NCG020811_COMPLETE FILE - HISTORICAL_20170714

STORMWATER DIVISION CODING SHEET
RESCISSIONS
PERMIT NO.
DOC TYPE
❑COMPLETE FILE -HISTORICAL
DATE OF
RESCISSION
❑
YYYYMMDD

<,a 1
July 14, 2017
NCDEQ— Division of Energy, Mineral & Land Resources
Att: Stormwater Billing
1612 Mail Service Center
Raleigh, NC 27699-1612
To Whom it may Concern:
This property was sold to North Carolina Wildlife Federation on August 31, 2016.
We are requesting to resend all mining permits for this property.
We appreciate your services.
John R. Lane, Jr.
433 Gates School Road
Gates, NC 27937
Permit Number NCG020811
Gates County
Eure Sand Mine

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENTAL QUALITY
INVOICE
Annual Permit Fee
Illlil'lIV'IIdIN 111"IIiIIIIIIIUIIi� �dll
Open
This annual fee is required by the North Carolina Administrative Code. It covers the administrative costs associated with
your permit. It is required of any person holding a permit for any time during the annual fee period, regardless of the facility's
operating status. Failure to pay the Fee by the due date will subject the permit to revocation. Operating without a valid
permit is a violation and is subject to a $10,000 per day fine. 1f the permit is revoked and you later decide a permit is
needed, you must reapply, with the understanding the permit request may be denied due to changes in environmental,
regulatory, or modeling conditions.
Invoice Number: 2017PR004637 Annual Fee Period: 2017-07-01 to 2018.06-30
Permit Number: NCG020811 Invoice Date: 06106/2017
Gates County
Eure Sand Mine Due Date: 07/06/2017
John R. Lane Jr.
Annual Fee: $100.00
433 Gates School Rd
Gates, NC 27937
Notes:
1. You may pay either by mail with checklmoney order OR by electronic payment (eCheck or Credit Card).
2. If payment is by check/money order, please remit payment to:
NCDEQ - Division of Energy, Mineral and Land Resources
Attn: Stormwater Billing
1612 Mail Service Center
Raleigh, NC 27699-1612
3. If payment is electronic, please see http:lldeg.nc.gov/stormwater-e2ayments to pay electronically. Payments by eCheck will
debit your checking account. Credit card transactions will incur a convenience fee.
4. Please include your Permit Number and Invoice Number on all correspondence.
5. A $25.00 processing fee will be charged for returned checks in accordance with North Carolina General Statute 25-3-512.
6. Non -Payment of this fee by the payment due date will initiate the permit revocation process.
7. Should you have any questions regarding this invoice, please contact the Annual Administering and Compkance Fee
Coordinator at 919-707-9220.
Invoice Number:
2017PR004637
Annual Fee Period: 2017-07-01 to 2018-06-30
Permit Number:
NCO020811
Invoice Date: 61612017
Gates County
Eure Sand Mine
Due Date: 716/2017
Annual Fee: $100.00
John R. Lane Jr.
433 Gates School Rd
Gates, NC 27937
Check Number:

Compliance Inspection Report
Permit: NCG020811
SOC:
County: Gates
Region: Washington
Contact Person: John R Lane
Effective: 03/17/16 Expiration: 09/30/20 Owner: John R Lane
Effective: Expiration: facility: Eure Sand Mine
Fort Island Rd
Gates NC 27937
Title: Phone: [phone]
Directions to Facility:
From intersect of NC 37 & NC 137 in downtown Gatesville, go west 4A miles on NC 137 to intersect of Taylor Mill Rd (SR 1118),
travel south on Taylor Mill Rd 1.6 miles, taking second paved left onto Fort Island Rd, go south 0.5 miles on same rd turn rt.
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Reprosentativo(s):
Related Permits:
Inspection Date: 12/11/2017 EntryTime; 10WAM
Primary Inspector: Thom Edgerton
Secondary Inspector(s):
Exit Time: 10:30AM
Reason for inspection: Routine Inspection Type
Permit Inspection Type: Mining Activities Stormwater Discharge COC
Facility Status: © Compliant [] Not Compliant
Question Areas:
Storm Water
(See attachment summary)
Phone: [phone]
Compliance Evaluation
Page: 1

Permit: NCG020811 Owner- Facility: John R Lane
Inspection Date: 1211112017 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
I visited the site and could not see that more than a 10' x 10' hole had ever been dug at the site. There are game land signs
along the road frontage, so I agree as was noted in the comments of RIMS; the permittee stated that the property had been
sold to the Wildlife Federation on 8/31/2016. It is OK to rescind the permit.
Page: 2

December 9, 2015
Energy, Mineral
and Land Resources
ENVIRONMENTAL OUALITV
John Lane
Attn: John Lane
433 Gates School Rd
Gates. NC 27937
PAT MCCRORY
G... ... „
DONALD R. VAN DER VAART
Subject: NPDES Stormwater Permit Coverage Renewal COC #NCG0208 l 1
Dear Permtttee:
TRACY DAVIS
1)m,o,
For coverage under NPDES General Permit NCG020000, the Division of Energy, Mineral and Land
Resources (DEMI-R) is forwarding herewith the reissued Certificate of Coverage and
Stormwater/Wastewater General Permit. This permit is reissued pursuant to the requirements of North
Carolina General Statute 143-215.1 and the Memorandum of Agreement between the state of North
Carolina and the U.S. Environmental Protection Agency, dated October 15, 2007 (or as subsequently
amended.) The following information is included with your permit package:
• New Certificate of Coverage
• SLormwaterlWastewater General Permit
• Technical Bulletin for the General Permit
• Discharge Monitoring Report (DMR) Forms
• Annual Discharge Monitoring Report Forms
• Qualitative Monitoring Report Forms
The General Permit authorizes discharges of Stormwater and/or wastewater (as applicable to your site),
and it Specifies your obligations with respect to discharge controls, management, monitoring and record
keeping. Please review the new permit to familiarize yourself with all changes in the reissued permit.
Significant changes to the General Permit are outlined in the Technical Bulletin.
Your coverage under the General Permit is transferable only through the specific action of DEMLR. This
permit does not affect the legal requirements to obtain other permits which may be required by the N.C.
Department of Environmental Quality, nor does it relieve the permittee from responsibility for
compliance with any other applicable federal, State, or local law, rule, standard, ordinance, order,
.lodgment or decree.
If you have any questions regarding this permit package please contact the DI ---MLR Stormwater
Permitting Program at 919-707-9220.
Sincerely,
fim- Tracy E. Davis, P.E., C.P.M
Cc: Stormwtlter Permitting files
Slate of North Carolimi I Environmental Quality I Energy, Mineml and Land Resource%
1612 Mnil Service Center 1 512 North S:Jiahury Streel I Raleigh, NC 27699-I612
919 707'1200 1'

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG020000
CERTIFICATE OV NCGO20811
STQRMWATER AND WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
John Lane
is hereby authorized to operate approved wastewater treatment systems) and discharge
stormwater and/or wastewater, as approved in the original permit/application or
subsequent permit modification, from a facility located at:
Eure Sand Mine
Fort Island Rd
Gates
Gates County
to receiving waters designated as CHOWAN RIVER, a class B;NSW water in the Chowan
River Basin, in accordance with the effluent limitations, monitoring requirements, and
other conditions set forth in Parts I, 11, 111, and IV of General Permit No. NCGO20000 as
attached.
This certificate of coverage shall become effective October 1, 2015.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day October 1, 2015.
for Tracy E. Davis, P.E., CPM
Director, Division of Energy, Mineral and Land Resources
By the Authority of the Environmental Management Commission

FTWA
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
John R. Lane
Eure Sand Mine
433 Gates School Road
Gates, NC 27937
Dear Mr. Lane:
John E. Skvarla, III
Secretary
July 15, 2014
Subject: General Permit No. NCG020000
Eure Sand Mine
COC NCG020811
Gates County
In accordance with your application for a discharge permit, we are forwarding
herewith the subject certificate of coverage to discharge under the state stormwater - NPDES
general permit for mining operations. This permit is issued pursuant to the requirements of
North Carolina General Statute 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection Agency dated October 15, 2007 (or as
subsequently amended).
Please take notice that this certificate of coverage is not transferable except after notice
to the Division of Energy, Mineral, and Land Resources. The Division may require
modification or revocation and reissuance of the certificate of coverage.
Please be aware that mine dewatering at your site has the potential to impact adjacent
wetlands. Your application indicated that you would have only stormwater discharge from
your facility, if activities at your site change and there is a need for dewatering activities you
will need to modify this permit coverage along with your mining permit (37-06) to allow for
dewatering activities.
Please note that the attached pcnnit expires on December 31, 2014. Your COC will be
auroincrricalIV renewed to cover the full 5 year tenn of the soon to be reissued pen -nit. In the interim
you must abide by the terms of the expiring permit. You can review the proposed general permit
changes once they are posted at: http://portal.ncdenr.org/web/lr/public-notices
Division of Energy, Mineral, and Land Resources
Energy Section - Geological Survey Section - Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 - Internet: http://portal.ncdenr,org/web/Ir/
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110%p Post Consumer Paper

John R. Lane
July 15, 2014
Page 2
This permit does not affect the legal requirements to obtain other permits which may
be required by the Division of Energy, Mining, and Land Resources, or permits required by the
Division of Water Resources (including 401 certifications, etc.), Coastal Area Management Act,
or any other federal, state or local governmental permit that may be required.
If you have any questions concerning this permit, please contact Bradley Bennett at
telephone number [phone].
Sincerely,
ORIGINAL SIGNED BY
BRADLEY BENNETT
for Tracy E. Davis, P.E., CPM
cc: Washington Regional Office
Central Files
Stormwater Permitting Program Files

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCG020811
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
John R. Lane, Jr
is hereby authorized to discharge stormwater from a facility located at
Eure Sand Mine
Fort Island Road
Eure
Gates County
to receiving waters designated as the Chowan River, a class B; NSW water in the Chowan River
Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions
set forth in Parts I, 11, 1I1, IV, V, and VI of General Permit No. NCG020000 as attached.
This certificate of coverage shall become effective July 15, 2014.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 15. 2014.
ORIGINAL SIGNED BY
BRADLEY BENNETT
for Tracy E. Davis, PE, CPM, Director
Division of Energy, Mineral and Land Resources
By the Authority of the Environmental Management Commission

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NCG020811
R'
S
Map Scale 124, 000
John R. Lane, ]r.
Eure Sand Mine
Latitude: 360 23' 58" N
Longitude: 760 MY 54" W
County. Gates
Receiving Stream: Chowan River
Stream loss: B; NSW
River -basin: Chowan
Fti���wAurlf�l•- L:':y
Facility Location

�t
Bennett, Bradley
From:
Edgerton, Thom
Sent:
Friday, May 03, 2013 11:11 AM
To:
Bennett, Bradley
Cc:
Dumpor, Samir
Subject:
FW: NCG020831, NCG020811, NCG020791 status updates
Hello,
Samir and I discussed the 3 projects again after our phone discussion earlier this week.
NCG020831— 74-90 — Dupree Pit— Pitt County: I have received the final 0&M Plan and will be getting to the approval
letter soon. The site is still working with the USACE, and the PCN will incorporate the 401 process. WaRO DWQ has no
concerns with the continued permitting.
NCG020811— 37-06 — Eure Sand Mine — Gates County: WaRO DWQ has no concerns with the continued permitting.
NCG020791— 52-15 —Johnson Mine —Jones County: DEMLR issued the mining permit with no dewatering. A mining
permit modification will be required to dewater. DWQ will require an O&M Plan and NPDES permitting at that time, if
that occurs. WaRO DWQ has no concerns regarding the present operation.
Please feel free ton contact Samir or myself with any questions.
Thanks,
Thom
Thom Edgerton, Environmental Engineer
Division of Water Quality
Surface water Protection Section
Washington Regional Office
North Carolina Department of Environment and Natural Resources
[phone] Office
[phone] Fax
Email correspondence to and from this address may be subject to the North Carolina Public Records Law
and may be disclosed to third parties unless the content is exempt by statute or other regulation.
From: Edgerton, Thom
Sent: Tuesday, April 16, 2013 4:46 PM
To: Bennett, Bradley
Cc: Dumpor, Samir; Novak, Gary; Wehner, Judy; Mcclain, Pat; Adams, Amy
Subject: FW: NCG020831, NCG020811, NCG020791 status updates
Hello,
See the responses incorporated below in blue.
Please let me know if you need additional information or action taken.
Thanks,
Thom
Thom Edgerton, Environmental Engineer
Division of Water ouality
Surface Water Protection Section
Washington Regionai Office
1

North Carolina Department of Environment and Natural Resources
[phone] Office
[phone] Fax
Email correspondence to and from this address may be subject to the North Carolina Public Records Law
and may be disclosed to third parties unless the content is exempt by statute or other regulation.
From: Patterson, Robert
Sent: Friday, April 12, 2013 1:46 PM
To: Edgerton, Thom
Cc: Bennett, Bradley
Subject: NCG020831, NCGO20811, NCGO20791 status updates
Thom,
I wanted to follow up on these 3 permits that Brian was working on before he left.
NCG020831 - 74-90 - Dupree Pit - American Materials Company, LLC - Pitt County
1. Did they ever submit an approvable Pumping O&M Plan to you? Yes, I have received adequate information.
Today I requested a final O&M Plan (not marked Draft) be submitted.
2. Either way, does WaRO have any concerns with issuing it? WaRO has no concerns with the issuance of the COC.
Upon this (Robert Patterson's) request, I notified the consultant stating that I had not received the signed JD
map and the required information was promptly submitted. Roberto Scheller [phone] stated that he
does not see that a 401 PCN has been received (logged in) for the proposed haul road improvements/stream
crossings. Roberto stated, that noting the remaining requirements in the permit(s), would eliminate the need to
delay issuance. WaRO's recommendation is to issue the COC & DEMLR Permits and note the required.
NCGO20811 - 37-06 - Eure Sand Mine —John R Lane, Jr. - Gates County
1. Did they ever submit an approvable Pumping 0&M Plan to you? Samir reviewed this project and states the
requirements were adequately fulfilled.
2. Either way, does WaRO have any concerns with issuing it? WaRO recommends issuance.
NCG020791 - 52-15 - Johnson Mine - Johnson Contracting, Inc. - Jones County
1. Did they ever reply to your add. info. request dated 9/30/2011? Only verbally. When I last spoke -to Brian
Lowther regarding this operation, he stated that the Mining Permit had been issued without dewatering. I had
spoken to the consultant numerous times detailing exactly what was required to create an acceptable O&M
Plan.
2. That A.I. is the last correspondence we have on this application. Do we or you have access to DEMLR's Permits
electronically? If there is no WW discharge from the permitted boundary, WaRO has no concerns.
Please let me know if you need additional information.
Thanks,
Thom Edgerton
[phone]
Today is my last day, so please send any replies to Bradley. Thanks!!
Robert D. Patterson, Pit
Environmental Engineer
NCDENR I DWQ I Storruwater Perrnitting
1617 Mail Scre,ice Center, Raleigh, NC 27699-1617 ltLA 1 512 N, Salisbury St., 91h Floor, Raleigh, NC 27604 Location & ]',,heels
(919) 807-637;i l'honr, 1 (91.9) 807-6494 Fax I Robert.f'atterso a,ncdenr.gov Finail I htt : /0ortal.ne(lenr.org/web/wq/ws/sti Wchsitc
b.A1.3eforr printing this email, please consider your hudgel and the environment.
2

E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties unless the content is
exempt by statute or other regulation.

DMr. Brian Lowther
NC Department of Environment and
Natural Resources
Division of Water Quality
1617 Main Service Center
Raleigh, NC 27699-1617
Dear Mr. Lowther:
Elliott Consulting
622 Rocky Hock Creek Road
Edenton, North Carolina 27932
Phone: [phone]
Please find attached to this letter 2 copies of mine maps, topographical maps, location maps and wetland
delineation survey maps in relation to the Eure Sand Mine project in Gates County (John Lane, applicant) we
talked about last week. If you have any further questions or need further information, please let me know.
Regards,
C�
C
KEN ELLIOTT
goygy
DEC X 9 2011
DENR- WATER 00AL1Ty
WEWDSAND STORPAWATER &FANCH

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PONDS #5-1U
OVERVIEW MAP
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SEPT 22. 2011 •:.:.. •• r i
REVISED DEC: 15, 2011
KEN ELLIOTT CONSULTING •.•� �Y ��F� . �r
�Ilr
SITE INFORMATION
TOTAL PERMIT AREA - 322.60 AC
TOTAL UNDISTURBED - 292.35 AC �•" � �•' rli� �..vq�
TOTAL WETLANDS - 173 04 AC 4
�. S-R 24-..2�6 +• R E�.
PROCESSING AREAS - 1.79 AC .' .• ' s���;
ROADS (INCL THRU WETLANDS) - 1.99 AC .•' • q
UNEXCAVATED BUFFERS - 9.98AC
EXCAVATlQN - 16 4E3AG .•' � �,.
• WETLANDS
w

VICINITY MAP (NOT TO SCALE)
SITE iNFORMATION
N/F
J. ROGER LANE
AREA IN R/W
RITA -I, LAJNE
27740 SF
D° 263 PG 640
0.637 A.0
PARCEL NO. 0200505
ARLA 'N TRACT
TOTAL AREA
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1:1873269 SF
271.936 AC
272.5,13 AC
AREA IN WFiLANDS
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' 46.935 AC
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EVRE SAND MINE
PONDS #5&6
MINING MAP
SCALE 1" z i50'
JOHN R. LANE, JR
EVRE, NC
GATES COUNTY
SEPT 22. 2011
REVISED DEC 15, 2011
KEN ELLIOTT. CONSULTING
SITE iNFORMATION
TOTAL PERMIT AREA - 322.60 AC
TOTAL UNDISTURBED - 292-35 AC
TOTAL WETLANDS - 173.04AC
TOTAL PROCESSING AREAS - 1 79 AC
TOTAL ADD'L ACCESS ROADS - 1.99AC
UNEXCAVATED BUFFERS - 9.98 AC
TOTAL EXCAVATION AREA - 16.48AC
TOTAL AFFECTED AREA- 30 25AC
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JOHN R. LANE, JR.
SURE, NC
GATES COUNTY
SEPT 22, 2011
REVISE() DEC 15, 2011
KEN ELLIOTT. CONSULTING
SITE !NFORMATION
TOTAL PERMIT AREA - 322 60 AC
TOTAL U N DISTIJ R 6 E D - 292.35 AC
TOTAL WET LANDS - 173 04AC
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PROCESSING AREAS - 1 79 AC
ROADS (INCL THRU WETLANDS) - 1 99 AC
UNEXCAVATED BUFFERS - 9 98AC
EXCAVATION - 16 48 AG AlWiACC4h�6
•

I OC,NITY MAP (NOT TO SCE) I
INFORMATION
N/F
J. ROGER LANE
AREA IN R/W
RITA H. LANE
27740 SF
D3 263 PG 640
0.637 AC
PARCEL NO. 0200505
AREA iN TRACT
TOTA.1 AREA
1'845529 SF
11873269 SF
271.936 AC
272.573 AC
AREA IN WETLANDS
640C489 SF
1. 46.935 AC
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CEORGE MAC MILLER
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CHARLES T. HOFLER
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HALL TOWNSHIP, GATES COUNTY
NORTH CAROLINA
.,T 2-0 SHEET 1 OF 2
c-

North Carolina
Beverly Eaves Perdue
Governor
Mr. John R. Lane, Jr.
433 Gates School Road
Gates, NC 27937
Dear Mr. Lane:
A AJ;A
=
NCDENR
Department of Environment and Natural Resources
Division of Water Quality
Coleen H. Sullins
Director
December 13, 2011
Subject: General Permit No. NCG020000
Eure Sand Mine, NCG020811
Gates County
Dee Freeman
Secretary
The Division of Water Quality's Stormwater Permitting Unit received a National Pollutant Discharge
Elimination System (NPDES) permit application for Eure Sand Mine on December 2, 2011. The application
included a copy of an associated application for a mining permit submitted to the Division of Land Resources
(DLR). Please be aware that the issuance of an NPDES permit is contingent upon the issuance of an
associated mining permit from DLR. Our office will process your stormwater permit application once a
DLR mining permit has been issued for your project.
Please also be aware that if your project is located near wetlands, your NPDES permit will require
dewatering operations without wetland impacts. The specific requirements for mine dewatering at facilities
near wetlands can be found in the text of general NPDES mining permit number NCG 020000 available
on our website, http://portal.ncdenr.org/web/wq/ws/su/npdessw, See Part I11, Section E of the permit. An
approved Operation and Monitoring Plan is required for NPDES-permitted mining facilities and may he
required prior to permit issuance. Discharging mine dewatering wastewater without Plan approval will be
subject to enforcement action. A Plan for your facility must be submitted to the Washington Regional Office
within 60 days of your receipt of an NPDES permit. We encourage you to contact Thom Edgerton at the
Washington Regional Office at [phone] to address any wetland concerns for your facility in order to
ensure a successful NPDES application review.
If you have any questions concerning the NPDES permit approval process, please contact me at telephone
number [phone].
Sincerely,
Brian Lowther
Environmental Engineer
cc: Washington Regional Office, "Thom Edgerton
Central Files
Stormwater Permitting Unit Files
1617 Mail Service Center, Raleigh, North Carolina 27699.1617
Location: 512 N. Salisbury St. Ralegh, North Carolina 27604 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-6 23 -6748 NorthCarolina
Internet: www.ncwaterquaiity.org �aturatlr�
Air Equal opportunily 1 ARrmative Aclion Employer

Dennison, Laurie
From: Adams, Amy
Sent: Monday, December 05, 2011 8:22 AM
To: Dennison, Laurie
Subject: Re: Clarification Needed Please
Lauric.
The consultants are used to working in VA and are struggling through oul• process. I'd recommend calling
them. They do have to apply for both the N111)ES and the 401.
Sent 1-rom my U.S. Cellular Android device
----- Reply message -----
From: "I)en111SOI1, Laurie." <]curie.j.derinisorl(c7ncdenr.LoN'>
Date: Mon, Dec 5, 2011 8:1 1 am -
Subject: Clarification Needed Please
To: "Hodge, Al" <al.hodg;e cr,Ilcderingov>, "Scheller, Roberto" <roberto.schel lei cr ncdenr.s ov> "Hackney,
Karen" <kart' il.haukne 1 nccdenr.roy>, "Adams, Amy" <an1V.aC1ilI11S Cl,]1C[1C n]',4�OV>
Cc: "Bennett, Bradley" <bradley. bennett 1 nncdc11r.�-ov>, "MC11111lan, Ian" <inn.mcmillurl(ir�,ncdenr, >
Hello Washington RO -
On Friday we received in-house the stornlwatcr NPDES application & S 100 fee for Enure Sane[ Minc.
My confusion conles fi'onl the fact that there was also a PCN in the package Ior a N W 14 with 0.482 ac of
wetland impact ... but no $240 fee & only 2 PCN copies.
Can anyone shed any light on this? I'll check with Bradley & lan too.
I'hanks, L -
L. Ririe DC11111SOI7
Administrative Assistant
[phone]
Wetlands, Buffers, and Stormwater, Compliance and Permitting Unit (WEBSCAPE)
NCDLNIZ/Division of Water Quality - Wetlands and Stormwater Branch
Mailing; address: 1650 Mail Service Center Raleigh NC 27699-1650
Physical location: 512 N Salisbury St 91h I'L Archdale Bldg Raleigh NC 27604-1 170
Fax i i ne: [phone]
Webslte:\\'\\'1\'.nC\\'Lllel'C1UaIlt)`.O]'g<blip:��\i'\i'\i',nClVillerClLlallll'.(?I'f�>
Email correspondence to and fi-on1 this address is subject to the North Carolina Public Records Law and nla)' be
disclosed to third parties unless the content is exempt by stature or other regulation.

APPLICATION FEE OF $100 WILL BE SENT TO NCDENR IN SEPARATE
MAILING FROM JOHN R. LANE, JR. / LANE FARMS.
RECEIVED
NOV 2 3 2011
DWQ..wARO

u310

§ D
F'LI.,IOTT C0NSULTING
,by7p11
November 17, 2011 DSM'DSTg�FNRWArCR,2jj }
TO Whorn It. j\day Cornccrn: �RB�NCh'
This mine permit app€icltipn is for ,i new 18.82-,tcre sand mine exCm ition (1- Eire Sand
Mine) constructed by John 1k. L'anc, jr., on leased property off Dort: Island Road (SR 1220),
Rt. 1, 1"ure, NC 27944, in Gates County. The requested permit ,area encompasses 2 parcels
of land rotaling; 322.6 acres, both of which are owned or partially owned by :,ir. L,ine's
Family. Of the 322.6 acres, the property consists of 173.04 acres of pocosin wetlands,
deline.acd in 2010. These `vetl:tnds are scatrcred -ibout the property, leaving; some ,tre;Is Of
Slightly higher sandy land in non -wetland areas which are suitable for excM<<ttiorl.
At this time, iMr. I.;,u1c plans to excavate 6 small ponds totaling 18.82 acres, as follows:
Pond #5 — 0.49 acres, Pond #6 — 3.44 acres, Pond #7 - 8.10 acres, ]Fond #8 — 4.75 act-cs,
Pond #9 - 0.38 acres, fond # 10 — 1.68 acres. Ponds #1-4 (phase 2) in the north of the
permit area and a third area (phase 3) inside the western end of the permit area will he
excavared near the cornpletion of the previous ponds, and will be requested to be permitted
by modification of the current permit at that time.
To reach the excavation areas it will be necessary to cross six areas of wetlands oil a I5-1t
wide sand access road. 'These roads are mostly pre--cxistirrg anti arc shown on the current.
USACE'. delineation map. 1`0tal length of these roads is 1403 feet and will impact. 0.483
acres of wetland. All roads through the wetlands will have silt fence installed along; their
perimeters and will have any other sediment and erosion controls required by USACF. A
Pre-Const:rucrion Notice for a Nationwide '14 Permit (Linear (70r7strUC1i0n across Wctlands)
is being submitted to USACE": and D1C/(-) at this time.
i%,Ir. Lane is also required to apply for a Special Use Permit ,.Ind a honing Compliance
Permit with Gates County, which is being done,tr this tirne.
All ponds are being located a minimum of 75 feet from delineated wetland boundaries.
F'ach pond will have a 50-ft undisturbed buffer around excavation areas and processing
areas, and each pond will have a 25-ft cuiexc,Ivated buffer .iround the cxc tv.Ition
containing roads & bcrrns. There will be an 8'x3' sand berm established and maintained
,rlong the outer edge of all unexcavated hLrfCt-S ,Intl processing; acres to prevent offsitc
erosion into adjacent. wetlands.
The excavation ,trey is located geographically 0.4 mile from the nc;trest dwelling and 0.4
mile from the nearest public highway in a lightly populated area, and is accessible only by a
private, gated access road. Distance from highways and dNvcllings along with wooded areas
and Fields on all sides of the excavation area provide adequate screening of the mining
operation, and the site is not visible from the closest highway. Acccss to the permit area is
limited by private property, and private road access.
Upon receipt of the approved permits from I\7CD1I\rR ]..and Quality and USACI'., iMr.
Line plans to excavate the sand pits to an average depth of 15 feet below natural ground
level, and will include construction of proper cut slopes on all sides of the cxcavatcd area, ;.ts
required in the permit. Reclamation of the mine area will include grading, leveling, and

— 2 — November 17, 2011
grassing of all affected areas. N[r. Lane plans to seed all sloped areas with ground cover ro
17rovide good erosion control.
All :adjacent 1,rndowners have beeta contacted and have been rmidu snwarc of the
proposed ruining and dewatering operation. The Gates Count` a'l71,111ager ilsas I?ee:l contacted
regarding this application and land entry agreements have been obtained. The mine area will
he well marled with warning grid keep out signs to Prevent itladvertent public access.
Sequence Of events for the development and operation OF the :nine:
1. ticquire proper permits morn \aC Department of l?nvirorrmcrit ,grad
N,itural Resources, US Army Corps of En'neers, & C.f1N A.
2. Acquire honing Compliance Permit & Special Use Permit From
Gates County Dept of Planning & Development.
3. 2-parcel tract totaling 322.6 ,acres will be permitted. Tracts contain
total '173.0 acres wetland pocosin (delineated 2010).
4. Phase 1 of project will be construction of G excavations totaling
18.82 acres, as Follows: fond a (O.49 acres), fond G (3.=44 acres), Pond
7 (8.10 acres), fond 8 (G4.7') ,►cres), fond 9 (0.36) acres), fond 'M ([.68
acres).
5. Phase 2 of project will cncornpass modification to permit
construction of Ponds "[ thru 4 inside of permit area ,at later time.
b. Phase 3 of project will encompass modification to permit
construction of Pond I l inside of permit arc;,r at later time.
7. All ponds will be Laid out on high land inside the permit ,arcs, and will
have ,a minimum 25-ft unexcavated buffer ,and a 50-ft undisturbed
bufFea' between the excavation and adjacent wetlands.
8. Operator will construct a 8-Ft wide by 3-Ft high sand berm around
each excavation area along the outside perimeter of the unexcavated
l)uFfcr to prevent offsite sedimentation.
9. Operator will install slit Fence: along existing access roads through
wetlands. Operator will instali slit fence along ,my new access roads
through wetlands per instruction From USACE
10. Starting with fond 10, each exc aratian arc.0 N%,il] in taarn first 11:1re
topsoil removes] down to 2.5 feet below natanal ground level and
stockpiled, and then sand will be du(; from cxc.avatiora areal by
excavator down to average 15 feet below existing natural ground
level, and stockpiled For hater removal from premises.
11. At this time there are no plans to de 'liter any of these; excavations.
t2. AMInitnum 2:1 graaded slopes will be established around edges of pond
area below groundwater level.
13. Nliraimum 3:1 graded slopes will be established around edges of pond
area above groundwater level.
14. .After excavation and edge slg]mg is completed, a low 1 Ft x 81-t berm
will be established around t11c entire perimeter of the excavated
pond, with outside slope graded Clown to natural ground level.
15. All slopes above water level will be Fertilized :Cud "'ceded wit11 ground
cover per guidelines From NC Agricultural 17.xtension Service.
16. Internal haul roads and processing- areas of main permit area will be
leveled and graded to natural ground level, to be returned to MMt.rral
field state., ,mv trash or debris cleaned up and rernoved.. A 1 Oft wide
Field path wit] remain ,around the entire perimeter of the cxc,av,tted
pond for owner ,.access.
17. Access roads & Field paths to I"ort Island Road will be graded,
leveled, ,and retur-nc:cl to pre-existing state.

— 3 — Novcmber 17. 2011
18. i_.litire affected area inside of main permit area will be fertilized and
seeded with groundcower :and will be allowed to return to it's prc--
existing Field state.
11). All silt fence erosion controls will be removed.
20. At end of permit period, affeced area returns to prc-e-xisting-, natural
state.
Si�,ned,
Ken 1=aliott:
Consulting for .John R.
Tune, jr.
622 ROCKY HOCK CREEK ROAD • G,[)EN-['ON, NORTH CAROLI`IA • 27932
J'HON1 : 252-482-8846 • FAX252-22I-B695

Akr-wA Division of Water Quality / Surface Water Protection
.%
NCDENRNational Pollutant Discharge Elimination System
NC rn C'/ NA D� of
EHYiI.oNNL rvF Aryl]
NCG020000
NOTICE OF INTENT
FOR AGENCY U51? ONLY
Date Receives
Yenr Month
Day,
Certi 1 i c�dc n f Cnvcr gc
NICIG10121DIRI
Check &
Arnount
100
Permit Assigned to
,r
National Pollutant Discharge Efimination System application for coverage under General Permit
NCG020000:
STORMWATER DISCHARGES associated with activities classified as:
SIC (Standard Industrial Classification) Code -14XX Mineral Mining Industry (except as specified below)
The following activities are also included:
• Active or inactive mining operations (including borrow pits —except for NCOOT borrow pits) that discharge
stormwater contaminated with or that has come in contact with, any overburden, raw t ! termediate
products, finished products, byproducts or waste products located on the site of such INU
• RY
Stormwater from vehicle maintenance activities at mining operations; v
• Overflow from facilities that recycle process wastewater; and/or DEC
• Mine dewatering (wastewater) 2 ��11
The following activities are specifically excluded from coverage under this General �1 D9"DSTO RMWA LIrY
aNa sra�lunrart:rZ ewvqcH
• Stormwater discharges associated with peat mining, coal mining, and metal mining;
• Stormwater discharges from mining operations which are intermixed on site with stormwater from asphalt
operations and/or concrete operations;
• Stormwater discharges associated with oil and gas extraction operations; and
Stormwater discharges associated with tourist gem mines
• NCDOT borrow pits are covered under NCS000150
The following discharges are covered by NPDES general permit NCG520000 instead of NCG020000:
• Point source discharges of stormwater and wastewater from in -stream sand mining operations (i.e., sand
dredging or dipping operations)
Far new mining sites that require an authorization to construct (ATC) wastewater treatment facilities: This
NOI is also an APPLICATION FOR an ATC for new wastewater treatment facilities. ATC requests must be
submitted at least 90 days prior to construction'.
For existing mining sites that require an Authorization to Operate (ATO) wastewater treatment facilities:
This NO! is also an APPLICATION FOR an ATO for wastewater treatment facilities in place.
Construction, modification, or installation of any new treatment components at an existing site requires an
ATC. (If the site is already covered by NCG020000, the ATC request may be submitted without an NOI).
Some wastewater treatment facilities used to treat or recycle wastewater at mining sites will require an ATC rp for
to construction per 15A NCAC 2H .0138. Please seethe NCG020000 Genera! Permit for details about which
treatment facilities require an ATC (summarized in Table 1 below). The authorization to construct or continue
to operate will be issued at the same time as the Certificate of Coverage (COC) for the NCG02 permit. Design of
treatment facilities must comply with requirements of 15A NCAC 2H .0138 & .0139.
Construction of wastewater treatment facilities subject to the AMATO requirements in the NCG02 permit
at new orexisting mining sites requires submission of three (3) sets of plans and specifications signed
Page 1 0# 9
'As per 15A NCAC 2H .0106
2Unfess treatment facilities are designed, constructed, and put into operation by employees internal to the company who are qualified to perlorm
such work for their respective companies in accordance with General Statutes, 89C•25 (7), plans and specifications must be signed and sealed
by a P.E.
SWU-NCG02-NOI Last revised 06/07/2010

NCG020000 N-O.I.
and sealed by a Professional Engineer (P.E.) or qualified staff2 along with this application. A copy of the
design calculations should be included. Please see auestions 18 & 19.
Table 1: Summary of Wastewater Permit Requirements
Quarterly
Monitoring?
Requires
A to C?
Mine Dewatering (MD)
Yes
No
Yes
No
MD Discharges that do not need treatment
other than E&SC to meet permit conditions
✓
✓
M D Discharges that need treatment other than
E&SC to meet permit conditions
✓
✓
Process Wastewater
Other Recycle
✓
✓
Closed Loop Recycle
✓
✓
Any Other Process WW
✓
✓
For questions, please contact the DWQ Regional Office for your area. {See page 7)
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Owner Name JOHN R. LANE JR.
Owner Contact JOHN R. LANE JR., KEN ELLIOTT
Street Address 433 GATES SCHOOL ROAD
City GATES State —NO _ Zf P Code 27937
Telephone No. 252-357-1279 Fax:
E-mail Address ritalane®embargmail.com, [e-mail]
2) Location of facility producing discharge:
Facility Name SURE SAND MINE
Facility Contact JOHN R. LANE, JR., KEN ELLIOTT
Street Address FORT ISLAND ROAD
City SURE, RT1 _ _ State NC ZIP Code
County GATES COUNTY
Telephone No. 252-357-1279, 252-339-9021 Fax:
Contact E-mail _ [e-mail], ken0kenobx.com
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). From intersection of NO 37 and NC 137 in downtown
Gatesville, qo west 4.4 miles on NO 137 to intersection of Taylor, Mill Road (SR 1118), travel south on Taylor
Mill Road 1.6 miles_, taking_ second paved left onto Fort Island Road (SR 1220), travel south 0.5 mile „on Fort
Island Road to dirt road entrance on the right.
4) Latitude 36'23"58.28"" Longitude-76°50"54.26" (degrees, minutes, seconds)
Page 2 of 9
SWU-NCG02-NOI Last revised 6/7/2010

NCG020000 N.O.I.
Permits:
5) This NPDES Permit Application applies to which of the following:
�I New or Proposed Facility Date operation is to begin JANUARY 2012
❑ Existing
❑ New Permit not applicable — ATC request only. NPDES Permit Number
6) Standard Industrial Classification:
Provide the 4 digit Standard Industrial Classification Code (SIC Code) that describes the primary industrial
activity at this facility
SIC Code: 1442
7) Provide a narrative description of the types of minerals mined at this facility:
SAND & TOPSOIL
S) Is this mine an inactive mine site?
J No
❑ Yes If yes, do you posses an "Inactive Renewal' from DLR and notified the DWQ Regional Office or
have you certified to the DWQ that the site has been stabilized? ❑ No ❑ Yes
9) Does this facility already have a valid Mining Permit from the Division of Land Resources (DLR)?
No If No, please indicate the status of the Mining Permit application: SUBMITTED OCTOBER 2011
❑ Yes if yes, please provide the Mining Permit number: Please also provide a
copy of your DLR Mining Permit with this DWQ application.
Note: DWO cannot issue a COC for the NCGO20000 General Permit until a Mining Permit is issued or
renewed by the Division of Land Resources (DLR).
10) Does this facility have any other NPDES permits?
❑ No
V Yes If yes, list the permit numbers for all current NPDES permits for this facility: _STORMWATER
SUBMITTED NOVEMBER 2011
11) Does this facility have any Non -Discharge permits (ex: recycle permits)?
V No
❑ Yes If yes, list the permit numbers for all current Non -Discharge permits for this facility:
12) Does total area of this mine site include ready -mix and asphalt areas?
V No
❑ Yes If yes, do they have DWQ stormwater permits (if owned by the same company)? ❑ No ❑ Yes
(provide permit number )
If not owned by the same company, who is the owner?
13) Will this mining operation precede development activities at this site?
V No
❑ Yes
14) Is this mine located within one of the 20 Coastal Counties and will it add more than 10,000 ft2 of impervious
surface?
Page 3 of 9
SWU-NCG02-NOI Last revised 6/7/2010

NCG020000 N.0.1.
❑ No
Yes If yes, you may be required to apply for an additional state stormwater permit. Check with your
local Regional Office. See contact information and checklist below.
15) Is this mine located the Neuse, Tar -Pamlico, or Catawba River Basin, or the Randleman or Jordan
Water supply Watersheds?
No
❑ Yes If yes, what size stream buffers are included on site? ft. Please show buffers in site plans.
Discharge Points, Receiving Waters & Wetlands:
16) Receiving waters:
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
and/or wastewater discharges end up in? CHOWAN RIVER
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer).
Receiving water classification (if known): B, NSW
Note: Discharge of process wastewater to receiving waters classified as WS-II to WS-V or SA must be
approved by the N.C. Dept. of Environmental Health. If DEH does not approve, coverage under
NCG020000 cannot be granted. No new discharges of wastewater are permitted in receiving
waters classified as WS-I or freshwater ORW_ Wastewater discharges to Saltwater ORW will
not be approved under the NCG02 General Permit.
17) if your facility has wastewater discharges and they are to HWO, PNA waters (Primary Nursery Areas) waters,
what is the flow rate? _ (See http://www.ncdmf.net/maps/FNA _maps/index.html, for map)
18) Discharge Points:
Number of discharge points (ditches, pipes, channels, etc. that convey discharges from the property):
Onsite: Stormwater: _1 Mine dewatering: Process Wastewater Overflow:
Oitsite: Stormwater: Mine dewatering: Process Wastewater Overflow:
Discharge points should be clearly marked on the submitted site plan.
Please provide short narrative description of discharges:
25 year stormwater overflow discharge only. Rainwater will drain back into excavation during normal
operations. Overflow will be sheet -flow rate across flat -top berm, or through notched spillway lied with ri rap_
a) Is your mine dewatering and discharging? (Answer only if you are dewatering)
No
Cl Yes If yes, where to? Surface Waters and/or Wetlands (on -site or off -site)
Other (on -site or off-sile) Describe:
b) Are you dewatering but not discharging? (Answer only if you are dewatering)
No
❑ Yes If Yes, please explain how you are dewatering, and where that water will be directed:
Page 4 of 9
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NCG020000 N.O.I.
19) Will mining operations require dewatering near wetlands or impact any stream, groundwater, or wetlands?
V No
❑ Yes
Note: Wetlands must be CLEARLY DELINEATED on the site plan. Mine dewatering activities that have
the potential to drain wetlands or otherwise impact surface water or groundwater MUST develop and
implement a Pumping Operation and Monitoring (O&M) Plan that has been approved by the
Division.
For sites that may drain wetlands — approval of a Pumping O&M plan may be required prior to
coverage under this general permit. The Pumping O&M Plan should be submitted to the
appropriate Regional Office and must be approved prior too eration.
The plan shall include, but is not limited to: (1) Groundwater monitoring strategies to demonstrate the
effect of pumping and to establish any pumping regime necessary to reduce impacts, and (2) Detailed
plans to maintain surrounding hydrology and respective monitoring to demonstrate compliance. See
checklist at end of document. Contact your local Regional Office for questions specific to your mine.
20) If you are dewatering, are there wetlands or surface waters within 400' of the mine pit perimeter?
V No, but wetlands are within 400' of mine pit, no dewatering
❑ Yes If yes, what distance are they from the mine pit perimeter?
21) Have you been required to obtain a 404/401 Certification permits?
❑ No
Yes If yes, please briefly describe below (include information such a required mitigation, BMPs, setbacks,
and/or O&M plans for on or off -site wetlands or other pertinent information). Attach other sheets as necessary:
22) Have you been required to obtain a wetland delineation certified by the US Army Corps of Engineers?
❑ No V Yes If yes, please attach to application submission.
Stormwater BMPs:
23) Does this facility employ any best management practices for stormwater control?
❑ No \/ Yes If yes, please briefly describe: attached
24) Does this facility have a Stormwater Pollution Prevention Plan?
V No ❑ Yes
If yes, when was it implemented?
25) Will vehicle maintenance activities occur at this facility?
No ❑ Yes
Page 5 of 9
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NCG020000 N.O.I.
Wastewater Treatment Facilities:
26) Will mine dewatering discharges occur? (An AMATO is required for wastewater treatment facilities'
dewatering discharges where E&SC devices alone will not meet effluent limits and/or protect water quality
standards).
No
❑ Yes
27) Will discharges of overflows from process wastewater treatment systems occur? (ATC or ATO required,
unless closed -loop recycle system)
V No
❑ Yes
If yes, answer the following questions for each wastewater treatment system:
Please describe the type of process used to treat and/or recycle the process wastewater. Give
design specifics (i.e. design volume, retention time, surface area, etc.). Existing treatment facilities
should be described in detail, and design criteria or operational data should be provided (including
calculations) to ensure that the facility can comply with requirements of the General Permit. Use
separate sheet(s))
b. Does this facility employ chemical additives to flocculate suspended solids? ❑ No ❑ Yes
If yes, please state the name, manufacturer and the quantity of average daily usage of the
chemical additive
Note: Please see our website for a list of evaluated polyacrylamide (DAMS) products for use in North Carolina.
C. Does this facility overflow only during rainfall events exceeding the 10-yr, 24-hr rainfall event?
❑ No % Yes, possibly
28) Are wastewater treatment facilities (including recycle systems) planned in the 100-year flood plain?
V No
❑ Yes If so, include information to demonstrate protection from flooding. (Minimum design requirements for
treatment works include protection from the 100-year flood, per 15A NCAC 2H .0219.)
Other:
29) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
V No ❑ Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
V No ❑ Yes
d) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
Page 6 of 9
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NCG020000 N.O.I.
How is material stored: _
Where is material stored:
How many disposal shipments per year:
Name of transport 1 disposal vendor:
Vendor address:
30) Are you applying for a mining permit in the same location as a previously permitted mine?
❑ No
-/ Yes If yes, specify permit number and name if known: Eure Sand Mine a -1 submitted Oct 2011, pending
31) Does your site have an active landfill within the mining permit boundary?
V No
❑ Yes If yes, specify type: ❑ LCJD ❑ Other:
32) Is your facility providing appropriate secondary containment for bulk storage of liquid materials? See permit
text online for secondary containment requirements.
V No
❑ Yes
Final Checklist:
This application will be returned as incomplete unless all of the following items have been included and
initialed for. Please show that the following required information has been included by initialing in each
space below.
Fee of $100 made payable to NCDENR
Completed application and all supporting documents
Copy of the valid approved mining permit (MP) for the facility or indication of MP application status
Copy of a county map or other general location map that shows the mining site and nearest major roads
Copy of USGS topographic map showing the mining site and surrounding areas, or other map that clearly
shows site location in relation to nearby streams, wetlands, and other waters, etc.
2 copies of large-scale site plan with topographical lines with all outfalls, applicable buffers and wetlands
clearly delineated
A copy of your DLR mining permit
A copy of your US Army Corps -approved wetland delineation if you marked "yes" to question 22 above.
If mine site is in one of the 20 Coastal Counties,
Applicant has checked with the appropriate regional office to verity the need for a Coastal State
Stormwater permit. Regional Office Contact:
Applicant has included a detailed list of impervious surface areas and percentages, sub -drainage
areas and total drainage area.
If the mine is dewatering and near wetlands, or may otherwise impact surface waters or groundwater,
include the following and contact -your local regional office about a Pumping O&M Plan (see below
for contact information). You may be required to provide an approved Pumping O&M plan prior to
NCG02 issuance.
2 copies of detailed Full Size Plans delineating areas on the plans and listing acreage (including:
wetlands, ditches, well -placements, pits, borrow areas, overburden storage, stormwater controls/BMPs,
vehicle maintenance areas, settling basins, product process (such as screening, stockpiles, waste
piles), total drainage area, impervious surface percentages (if state sw programs apply), applicable
buffers, and access and/or haul roads).
Well information (design, depths, maintenance)
Physical monitoring for the wetlands areas
Settling pond sizing information, it apphcabJe
Page 7 of 9
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NCG020000 N.O.I.
W.'I
Level spreader design, if applicable
Details about dewatering method
Cone of influence calculations
Description of measures to prevent erosion and flooding
Description & information about 4011404 permits that have been obtained
Copy of US Army Corps of Engineers wetland delineations or approved wetland delineation (if
applicable)
l have contacted my local regional office about a Pumping 0&M Plan.
Regional Office Contact: . Date contacted:
I will not any impact nearby wetlands, surface waters or groundwater by dewatering.
If an ATC or ATO is required, three (3) sets of plans, specifications, and design calculations, signed, sealed,
and dated by a P.E. ATC and ATO requirements in NCG02000 are summarized in Table 1 on Page 2 of
this NOI (see the permit text for more details). Plans shall show all pertinent design features, including the
location of the outfal#). If stormwater is flowing off -site, the plan must show that stormwater will not be
mixed with wastewater.
Certification., North Carolina General Statute 143-215.6 b (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a lake
statement of a material tact in a rulemaking proceeding or contested case under this Article; or who falsifies, tampers with, or knowingly
renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
[Environmental Managements Commission implementing this Article shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars (S10,000).
I hereby request coverage under the referenced General Permit. 1 understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I agree to abide by the following as a part of coverage under this General Permit:
1. I agree to abide by the approved Mining Permit for this mining activity. (A copy of the valid
mining permit must be attached to this request.
2. 1 agree to not discharge any sanitary wastewater from this mining activity except under the
provisions of another NPDES permit specifically issued therefore.
3. 1 agree that bulk storage of petroleum products and other chemicals shall have adequate
protection so as to contain all spills on the site.
4. 1 agree that solid wastes will be disposed of in accordance with N.C. statutes and rules
governing solid waste disposal.
5. 1 agree that maintenance activities for vehicles and heavy equipment will be performed so as to
not result in contamination of the surface or ground waters.
Page 8 of 9
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NCG020000 N.O.I.
1 agree to abide by the provisions as listed above and recognize that the provisions are to be considered as
enforceable requirements of the General Permit.
I certify that I am familiar with the information contained in this application and that to the best of my knowledge
and belief such information is true, complete, and accurate.
Printed Name of Person Signing: John R. Lane, Jr.
Title: Applicant / Owner
of
November 8 2011
(Date Signed)
Notice of Intent must be accompanied by a check or money order for $100.00 made payable to NCDENR.
Mail the entire package to:
Stormwater and General Permits Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Note
The submission of this document does not guarantee the issuance of an NPDES permit.
For questions, please contact the DWO Regional Office for your area.
DWQ Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office ...
[phone]
Mooresville Office...
[phone]
Raleigh Office ........
[phone]
Washington Office
...[phone]
Wilmington Office ...
[phone]
Winston-Salem ......
[phone]
Central Office .........(919)
B07-6300
Page 9 of 9
SWU-NCG02-NOI Last revised 6/7/2010

�\ 13
9 2�5 3
F I C- Gj O � RHC
Hank HOSBSVILLE, NC 27946
LANE FARMS-
P.O. BOX 187
GATES, NC 27937. 66-85/531 1.1/29/2011 $
252-357-1279
9
i
YTOOFE NCDENR-DWQ "100.00
One Hundred and 00/100",y,.****.,.,,,,.,«.**....**�����,.*,��t�.��..��..,.*,,****..*.*.,**���i+tt��},,�#a
DOLLARS
NCDENR-DWQ r
Aft: Samir Dumpor "
NC Div. Water Quality/Surface WaterlF�
943 Washington Sq, Mall ° %
Washington, N.C. 27889
MEMO
j` Jahn Lane NCG02 - permit ,t !

LANE FARMS
NCDENR-DWQ
9253
11 /29/2011
NCG02 - Permit 100.00

OPERATION AND MAINTENANCE PLAN
SAND MINE EXCAVATION — EMERGENCY OVERFLOW
Operator: John R. Lane, Jr., 433 Gates School Road, Gates, NC 27937
Job Location: Eure Sand Mine, Fort Island Road (SR 1120), Rt. 1, Eure, NC
County: Gates County
Prepared by: Ken Elfiott, consultant
Date: November 17, 2011
This plan defines responsibilities for operating the Eure Sand Mine safely, and that overflow wastewater
will not degrade or negatively impact any wetlands or waters of the state.
Description and Operation of the Eure Sand Mine:
Eure Sand Mine will be a group of 6 new excavations totaling 18.82 acres located 2.1 miles south of
Eure, NC on high sandy land adjacent to pocosin wetland. At this time Mr. Lane is filing an application
with DLR for a new permit for this excavation, along with a Nationwide 14 permit from the US Army
Corps of Engineers and a Stormwater Permit from NCDENR.
Because of adjacent wetlands on the tract Mr. Lane will be required to maintain a 50ft wide undisturbed
buffer (no mining activity) and a 25ft wide unexcavated buffer (may contain berms & roads) between
any excavation and the adjacent pocosin wetlands. The excavation areas and buffers will be carefully
marked to prevent mining activity from occurring outside of designated areas. Mr. Lane will be
constructing a sand berm around the perimeter of all unexcavated buffers so that all rainfall inside the
mining activity areas will drain back into the excavated pit instead of into the adjacent wetlands.
Sedimentation and Erosion Control
Temporary sand berm around perimeter of excavation area will be constructed with 3:1 slope on inside
and 2:1 slope on outside, with 2ft - 4ft flat top. Slopes will be sowed with ground cover after
construction for coverage within 7 days.
Berms & Rainfall Overflow Protection
During normal operation, rainfall on processing areas and interior roads will drain back into the
excavated pit. During times of excess rainfall causing'larger than designed peak flows, 2 types of
overflow protection will be used.
1. A level topped vegetated berm crest will be constructed on the entire berm system around each
excavation area. This provides a very flat berm top so that water will overflow along the berm
length in a thin layer so as not to create erosion problems.
2. A notched spillway will be located at the lowest end of each berm system and will be lined with
rock riprap and vegetation. This emergency spillway will be designed so that it will safely carry
the maximum expected flow from a 25-year storm.

Maintaining the Berm System
Inspections and maintenance are required to obtain the intended function of the berm system, and to
maintain the life of any adjacent wetlands or waters of the State. Items to inspect and maintain during
the 10 year life of the mine permit are:
• Jnspect embankments, berms and appurtenant structures, and repair as needed.
• Repair any damage to vegetated areas or berms with compacted earth fill, reshaping, sodding,
reseeding and mulching as needed.
• Inspect riprap spillway structures in berms regularly, replace dislodged rock as necessary.
Monitoring the Process and Effects of Dewatering
Analytical and qualitative monitoring of overflow mine wastewater will be in accordance with the
NCG020000 permit, as follows:
• All ponds in the Eure Sand Mine permit area will be inspected daily by the operator to identify
any abnormal conditions.
• All berms and erosion control and sedimentation control structures will be inspected following
significant (1/2-inch) rainfall events for damages, and all structures will be repaired immediately.
• Special inspections will be conducted immediately following severe storms, vandalism, and
other significant events.
• Overflow of mining wastewater after severe storms will be monitored bi-annually at three
stream sites on the property, located inside the wetland areas. Water samples (grab samples)
will be tested for pH, settleable solids, turbidity, and total flow. Samples will be collected and
tested onsite for pH, and the remainder will be tested for the remaining parameters by a North
Carolina certified lab.
• Rain gauge data will be collected by monitoring rain gauge data monthly and after each rain
event.
Records
Data will be collected as follows:
• Data will be collected from samples taken from wetland sampling sites after severe storm
events causing overflow from the excavation areas.
• Elliott Consulting will maintain the following records in a permanent file at the Elliott Consulting
office at 622 Rocky Hock Creek Road, Edenton, NC 27932: a record of all significant actions
taken; as -built drawings; permits; analytical results from sampling; and related material. Copies
of all inspections, monitoring reports and lab analyses shall be provided to NCDWQ on a regular
basis and as requested.

BMP Conditions
• The permittee will utilize best management practices to ensure that excavating Eure Sand Mine
will not degrade or negatively impact any wetlands or waters of the State.
Signed,
Ken Elliott
for John R. Lane, Jr.
November 17, 2011

Sand Berm with Overflow Rock Baffle / Weir
Practice Standards and Specifications 6.87 — Check Dam with Weir
Eure Sand Mine
Rt. 1, Eure, NC
Gates County
3FT X afT
CARD IER!
R 4F RAP & SMALLER G RAIEL
IrT SAND IER9
JUT X aFT
SAND IER■
Definition: Small stone dam structure with a weir outlet with sediment storage area on the upper side, installed in
sand berm.
Purpose: To reduce erosion in overflow drainage outlet during major rainstorms by reducing velocity of flow, and
provide sediment control.
Siting: To be placed at lower end of sand mine disturbed area perimeter berm (8ft x 3ft sand berm).
Aggregate Size: NC DOT Class B stone lined with NC DOT 45 or ##57 stone on upper side.
Construction Specifications: Keep center stone section 5 inches below top of sand berm. Place sediment control stone
minimum 1ft thick on upstream side of berm at weir. Provide 9ft long stone apron on lower side of berm to flush with
surrounding grade.
Maintenance: Inspect check dams weekly and after significant rainfall and repair immediately if needed. Clean out
limbs, sediment and other debris that could clog the weir. Add stones to check dam to maintain correct height.
Maintain vegetative ground cover on berm, repair berm erosion as needed.
Ken Elliott, consulting
November 17, 7011

North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue, Govemor
Date November 8, 2011
Name of Property Owner Applying for Permit:
John R. Lane. Jr.
Mailing Address:
433 Gates School Road
Gates NC 27937
Dee Frenman, Seantary
l certify that ! have authorized (agent:) Ken Elliott to act oil my
behalf, for the purpose of applying for and obtaining all DWQ / USACE .Perm its to
install or construct (activity) excavate and mine sand and topsoil
at (my property located at) Fort Island Road, Rt 1, Eure, NC in Gates County
This certification is valid thru (date) November 8, 2021
re
Date

x
NORTH CAROLINA
MINING PERMIT APPLICATION
State of North Carolina
Department of Environment
and Natural Resources
Division of Land Resources
Land Quality Section
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
[phone]
Revised: January 30, 2008

APPLICATION FOR A MINING PERMIT
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES
LAND QUALITY SECTION
APPLICATION FOR A MINING PERMIT
(PLEASE PRINT OR TYPE)
Name of Mine Eure Sand Mine County Gates
River Basin Chowan
Latitude (decimal degrees to four places) 36.3972
Longitude (decimal degrees to four places)-76,8594
Name of Applicant* John R. Lane, Jr.
Permanent address for receipt of official mail** 433 Gates School Road, Gates NC 27937
Telephone [phone] Alternate No, (252 ) 398-7708
4. Mine Office Address 433 Gates School Road, Gates NC 27937
Telephone ( 252 ) 398-7708 - --
5. Mine Manager John R. Lane Jr.
We hereby certify that all details contained in this Permit Application are true and correct to the best of our
knowledge. We fully understand that any willful misrepresentation of facts will be cause for permit
revocation.
***Signature Date September 16, 2011
Print Name John R. Lane, Jr.
"Title Operator
* This will be the name that the mining permit will be issued to and the name that must be indicated on the
reclamation bond (security) that corresponds to this site.
** The Land Quality Section must be notified of any changes in the permanent address or telephone number.
*** Signature of company officer required.
G.S. 74-51 provides that the Department shall grant or deny an application fora permit within 60 days of receipt ofa
complete application or, if a public hearing is held, within 30 days following the hearing and the filing of any
supplemental information required by the Department. All questions must be addressed and all required maps
provided before this application can be considered complete. Attach additional sheets as needed.

APPLICATION FOR A MINING PERMIT
NOTE: All of the following questions mist be thoroughly answered regarding your mining operation for
the intended life of the mine. All responses roust be clearly conveyed on a corresponding, detailed mine map.
A. GENERAL CHARACTERISTICS OF THE MINE
1. Answer all of the following that apply:
X
IN
If this is an application for a NEW permit, indicate the total acreage at the site to be covered by the
permit (this is the acreage that the "new permit" fee will be based upon): 322.6 acres
Of this acreage, how much is owned and how much is leased? Acres owned:
Acres leased: 322.6 acres Property owner if leased: _ J. Roger Lane (father), Rita H. Lane
mother Geor =e Mac Miller Charles T. Hofler, Jr,(partners)
If this is an application for RENEWAL of a mining permit, indicate the mining permit number and
the total (overall) acreage covered by the existing permit: Mining Permit No.:
Total permitted acreage (this is the acreage that the "renewal" fee will be based upon):
If this is an application for a MODIFICATION to a mining permit,
number and the total (overall) acreage covered by the existing permit.
Mining .Permit No.: Total permitted acreage:
indicate the mining permit
Does the modification involve acreage within the previously approved permitted boundary?
Yes ❑ No ❑. If yes, indicate the acreage to be covered by this modification (this is the
acreage that the "major modification" fee will be based upon).
Does the modification involve acreage outside the previously approved permitted boundary?
Yes ❑ No ❑. If yes, indicate the additional acreage to be covered by this
modification: (NOTE: you must complete all of Section F. ofthis application form
entitled Notification of Adjoining Landowners).
Of this acreage to be added to the permit, will any portion of this acreage be a.flected (i.e.: disturbed,
ground cover removed) by the mining operation? Yes ❑ No ❑ (if no, a "minor modification" fee
of $100.00 is required, despite the "undisturbed" acreage to be added). Ifyes, indicate the acreage to
be affected within the acreage to be added to the permit (the total acreage to be added to the permit is
the acreage that the "major modification" fee will be based upon):
If this is an application for TRANSFER of a mining permit, indicate the mining permit number and
the total (overall) acreage covered by the existing permit.
Mining Permit No.: Total permitted acreage:
SEE THE FEE SCH EDULE AT THE END OF THIS FORM FOR THE PROPER FEE AMOUNT TO BE
PAID FOR THE REQUESTED PERMIT ACTION(S) AND CORRESPONDING ACREAGE NOTED
ABOVE
2. Name of all materials mined: Sand & Topsoil
3. Mining method:
HHydraulic Dredge Front-end Loader & Truck ❑ Shovel & Truck
Dragline & Truck Self -loading Scraper
Other (explain): Excavator
4. a. Expected maximum depth of mine (feet) 20 feet
Depth is relative to what benchmark? (e.g., natural ground level, mean sea level, road elevation, etc.)_
Natural ground level
b. Expected average depth of mine (feet) 15 feet
-2-

APPLICATION FOR A MINING PERMIT
5. Has any area(s) at this site been mined in the past? Yes ❑ No
If yes, when and by whom was this activity conducted?
6. Number of years for which the permit is requested (10 years maximum): 10 years
13. MAPS
Clearly mark and label the location of your minim operation on six(d) copies of a 7.5-minute quadrangle
and a county highway map. These maps, in addition to six (61 copies of all mine maps and reclamation
maps, must be submitted with each permit application.
7.5-minute quadrangles may be obtained from the N.C. Geological Survey:
Mailing Address: Physical Address:
1612 Mail Service Center OR 512 North Salisbury Street, 5`" Floor
Raleigh, North Carolina 27699-1612 Raleigh, North Carolina 27604
[phone]
www, s reol ov. enr, state. nc.us/
County highway maps may be obtained from the N.C. Department of Transportation:
North Carolina Department of Transportation — Geographic Information Systems (GIS)
Mailing Address:
NC.DOT GIS Unit
1587 Mail Service Center
Raleigh, North Carolina 27699-1587
Physical Address:
NCDOT GIS Unit
3401 Carl Sandburg Court
Raleigh, North Carolina 27610
[phone]
www.ncdot.orL,Jit/gisContact/default.litmi
2. Mine maps must be accurate and appropriately scaled drawings, aerial photographs or enlarged
topographic maps of the entire mine site. All aspects of the mine site must be clearly labeled on the
maps along with their corresponding (approximate) acreage. As a reminder, mining permits can
Wily be issued for up to 10 years; thus, all mine and reclamation maps must only denote those
activities that are intended to be conducted during the life of the mining permit. All maps must be
of a scale sufficient (see minimum requirements listed below) to clearly illustrate the following, at a
minimum:
a. Property lines of the tract or tracts of land on which the proposed mining activity is to be located
including easements and rights -of -way.
b. Existing or proposed permit boundaries.
c. Initial and ultimate limits of clearing and grading.
d. Outline and width of all buffer zones (both undisturbed and unexcavated).
e. Outline and acreage of all pits/excavations.
f Outline and acreage of all stockpile areas.
g. Outline and acreage of all temporary and/or permanent overburden disposal areas.
h. Location and acreage of all processing plants (processing plants may be described as to location and
distance from mine if sufficiently far removed).
i. Locations and names of all streams, rivers and lakes.
j. Outline and acreage of all settling and/or processing wastewater ponds.
k. Location and acreage of all planned and existing access roads and on -site haul roads.
1. Location of planned and existing on -site buildings,
m. Location and dimensions of all proposed sediment and erosion control measures.
n. Location of 100-year floodplain limits and wetland boundaries.
o. Names of owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of
the mine tract, names of owners of record of tracts adjoining these tracts, that are within 1,000 feet of
the mining permit boundary, must be provided on the mine map,
- 3 -

APPLICATION FOR A MINING PERMIT
p. Names of owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary which lie directly across and are contiguous to any highway, creek, stream, river, or
other watercourse, railroad track, or utility or other public right-of-way. If an adjoining tract is owned
or leased by the applicant or is owned by the lessor of the mine tract, names ofowners of record of
tracts adjoining these tracts, that are within 1,000 feet of the mining permit boundary, must be
provided on the mine map(s). NOTE: "Highway" means a road that has four lanes of travel or less
and is not designated as an Interstate Highway.
q. Map legend:
1. Name of applicant
2, Name of mine
1 North arrow
4. County
5. Scale
6. Symbols used and corresponding names
7. Date prepared and revised
S. Name and title of person preparing map
Map scales should meet the following guidelines:
PERMITTED ACREAGE MAP SCALE
0-49 Acres 1 inch = 50 feet
50-199 Acres 1 inch = 100 feet
200+ Acres I inch = 200 feet
(NOTE: Smaller scaled maps may be acceptable if they clearly illustrate the above items)
-4-

APPLICATION FOR A MINING PERMIT
A table/chart must be provided on the mine map that clearly lists the approximate acreage of tailings/sediment
ponds, stockpiles, wastepiles, processing area/haul roads, mine excavation and any other major aspect of the
mining operation that is proposed to be affected/disturbed during the life of the mining permit. A table/chart
similar to the following will be acceptable:
CATEGORY
AFFECTED ACREAGE
Tailings/Sediment Ponds
Stockpiles
Access Roads
1.99 acres
Processing Areas
1.79 acres
Mine Excavation
18.82 acres
Unexcavated Buffers (roads, berms)
7.64 acres
=Fotalturbed Acreage
30.24 acres
NOTE:
IN ADDITION TO THE ABOVE, THE MAPS MUST ALSO INCLUDE ANY SITE -SPECIFIC
INFORMATION THAT IS PROVIDED IN THE ANSWERS TO THE FOLLOWING QUESTIONS IN
THIS APPLICATION FORM (PLEAVE NOTE_ THE ITALICIZED QU1--sFI0NS/STATEMENT.
THROUGHOUT THE FORM). THIS APPLICATION WILL NOT BE CONSIDERED COMPLETE
WITHOUT ALL RELEVANT ITEMS BEING ADEQUATELY ADDRESSED ON THE MINE MAPS.
-5-

APPLICATION FOR A MINING PERMIT
C. PROTECTION OF NATURAL RESOURCES
Describe in detail the sequence of events for the development and operation of the mine and reference the
.sequence to The mine Attach additional sheets as needed.
1. Acquire proper permits from NC Department of Environment and Natural Resources, US
Army Corps of Fngineers, & CAM.A.
2, Acquire Zoning Compliance Permit & Special Use Permit from Gates County Dept of
Planning & Development.
3. 2-parcel tract totaling 322.6 acres will be permitted. Tracts contain total 173.0 acres wetland
pocosin (delineated 2010).
4. Phase 1 of project will be construction of 6 excavations totaling 18.82 acres, as follows: Pond
5 (0.49 acres), Pond 6 (3.44 acres), Pond 7 (8.10 acres), Pond 8 (4.75 acres), Pond 9 (0.36
acres), Pond 10 (1.68 acres).
5. Phase 2 of project will encompass modification to permit construction of Ponds I thru 4
inside of permit area at later time.
6. Phase 3 of project will encompass modification to permit construction of Pond i I inside of
permit area at later time.
7. All ponds will be laid out on high land inside the permit area, and will have a minimum 25-ft
unexcavated buffer and a 50-undisturbed buffer between the excavation and adjacent
wetlands.
8. Operator will construct a 8-ft wide by 341 high sand berm around each excavation area along
the outside perimeter of the unexcavated buffer to prevent oftsite sedimentation.
9. Operator will install silt fence along existing access roads through wetlands. Operator will
install silt fence along any new access roads through wetlands per instruction trom USACE.
10. Starting with Pond 10, each excavation area will in turn first have topsoil removed down to
2.5 feet below natural ground level and stockpiled, and then sand will be dug from excavation
area by excavator down to average 15 feet below existing natural ground level, and stockpiled
for later removal from premises.
1 l . At this time there are no plans to dewater any of these excavations.
12. Minimum 2:1 graded slopes will be established around edges of pond area below groundwater
level,
13. Minimum 3:1 graded slopes will be established around edges of pond area above groundwater
level.
14. After excavation and edge sloping is completed, a low I ft x 8ft berm will be established
around the entire perimeter of the excavated pond, with outside slope graded down to natural
ground level.
15. All slopes above water level will be fertilized and seeded with ground cover per guidelines
from NC Agricultural Extension Service,
16. Internal haul roads and processing areas of main permit area will be leveled and graded to
natural ground level, to be returned to natural field state; any trash or debris cleaned up and
removed.. A 1 Ott wide field path will remain around the entire perimeter of the excavated
pond for owner access.
17. Access roads & field paths to Fort Island Road will be graded, leveled, and returned to pre-
existing state.
18. Entire affected area inside of main permit area will be fertilized and seeded with groundcover
and will be allowed to return to its pre-existing field state.
19. All silt fence erosion controls will be removed.
20. At end of permit period, affected area returns to pre-existing, natural state.
-6-

APPLICATION FOR A MINING PERMIT
2. Describe specific erosion control measures to be installed prior to land disturbing activities and during
minim to prevent offsite sedimentation (irrclrlde specific plans fvr •sedn)ren! crud ero.viarr calrlrol frrr nlir)c�
excavalioll(v), +vav(e piles•, crcce.vv/rrlirrc< r'oacly crlyd procesv areas), and -rive a detailed sequence of
installation and schedule for maintenance of the measures. Locate aml /agel all s•eclrr)renl and erosion
corllrol measures o1r the rllrlle 1114qp(S) alrcl provide 1}y)lcal cr'o.vv-.vecliorr.vleollsii-itelioil delaily Crf each
rrreasure. Engineering designs and calculations are required to justify the adequacy of any proposed
measures.
Operator will construct 8ft wide x 3ft tall temporary sand berm along the outside perimeter of the
unexcavated buffer of each excavation area to prevent offsite erosion. Berm will be grassed and
stabilized, and will be inspected weekly and repaired as needed,
Operator will establish silt fence erosion control along perimeter ofall access roads passing through
wetlands prior to land disturbing activities. Silt fence will either be constructed of standard strength
filter fabric with wire or polymer backing and steel posts set 8 feet apart, or extra strength filter fabric
between steel posts 6 feet apart. Silt fence will be inspected weekly and repaired as needed.
3. a. Will the operation involve washing the material mined, recycling process water, or other waste water
handling? Yes ❑ No ®. If yes, briefly describe all such processes including any chemicals to be used.
Not applicable.
b. Will the operation involve discharging fresh or waste water from the mine or plant as a point discharge to
the waters of the State? Yes ❑ No X. If}yes, hrief7}, describe the )rcrlw— of the ch.cchaige aml locate
all propo.ved di.charge porrll.v (along- L1'ith 1heii- inelhod of mahrh_ation) C)1r };our inhie r)lcrp(1�.
Not applicable.
- 7 -

APPLICATION FOR A MINING PERMIT
c. Will any part of the proposed mine excavation(s) extend below the water table? Yes ® No ❑.
If yes, do you intend to dewater the excavation(s)? Yes ❑ No E.
If yes, what impact, if any, will mine dewatering have on neighborin r wells? Estimated withdrawal rate in
gallons per day: I oecile till existing 1velhc on the mine Ihcrt lice 114thin
5(10 feet of the pt-oposecl e,rccr►,crtiofr crrec.r. Provide data to support any conclusions or statements made,
including any monitoring well data, well construction data and current water withdrawal rates. Indicate
whether the proposed mine locale is served by a public water system or private wells.
Not applicable.
d. If you answered yes to any of the above questions, provide evidence that you have applied for or obtained
the appropriate water duality permits) (Le., non -discharge, NpDES, Stormwater, etc.) from the Division
of Water Quality, Water Quality Section. In addition, the applicant is required to register water use with
the Division of Water Resources if the operation withdraws more than 10,000 gallons per day and needs a
capacity use permit from the Division of Water Resources if the operation lies in a capacity use area and
withdraws more than 100,000 gallons per day.
Not applicable.
4. a. Will the operation involve crushing or any other air contaminant emissions? Yes ❑ No 0.
If yes, indicate evidence that you have applied for or obtained an air duality permit issued by the Division
of Air Quality or local governing body.
Not applicable.
b. How will dust from stockpiles, haul roads, etc., be controlled?
Spraying water from water supply trucks on haul roads and process areas, or hauled & spread by
bucket on excavators will control dust. Stockpiles will also be sprayed with water weekly if
necessary to control dust. Speed limit on access roads will be maintained at I Omph maximum
-8-

APPLICATION FOR A MINING PERMIT
A buffer will be required between any mining activity and any mining permit boundary or right-of-
way. It may be an unexcavated buffer (no excavation, but roadways, berms and erosion &
sedimentation control measures may be installed within it), an undisturbed buffer (no disturbance
within the buffer whatsoever), or a combination of the two, depending upon the site conditions. Note
that all buffers must be located within the mining permit boundaries.
How wide a buffer will be maintained between any mining activity and any mining permit boundary or
right-of-way at this site? A minimum buffer of 25 feet is recommended, although a wider buffer may
be needed depending on site conditions. Shona all buffer locations and ►0dlhs on 1he mule nial)(s).
A 25-ft wide unexcavated buffer will be maintained around the excavation of each pond,
adjacent to an undisturbed buffer. This buffer will contain erosion & sediment control berms,
roadways, processing areas, and stockpiles.
b. A minimum 50 foot wide undisturbed buffer will be required between any land disturbing activities
within the mining permit boundaries and any natural watercourses and wetlands unless smaller
undisturbed buffers can be justified. Depending on site conditions, a buffer WJder than 50 feef may be
needed.
How wide an undisturbed buffer will be maintained between any land disturbing activities within the
mining permit boundaries and any natural watercourses and wetlands at this site? ,�ho,v all htrffer
localioils wid ividihs on the mule map(s).
A 50ft undisturbed buffer will be established around the excavation of each pond, and will be
located between the 2541 wide unexcavated buffer ofeach excavation and wetland pocosin.
G. a. Describe methods to prevent landslide or slope instability adjacent to adjoining permit boundaries
during mining. Minimum 2 horizontal to 1 vertical slopes or flatter for clayey material and minimum
3 horizontal to I vertical slopes or flatter for sandy material are generally required, unless technical
justification can be provided to allow steeper slopes.
Landslide or slope instability adjacent to adjoining permit boundaries will be prevented by
construction of graded cut slopes during mining activities. Slopes will have a minimum of 3
horizontal to l vertical gradient.
-9-

APPLICATION FOR A MINING PERMIT
b. Provide o cross-section on the whie nicip(s) for all fill slopes (herms, �v(.istel)iles, overburden
di.�posal cireas, ele), clearly indicating the intended side slope grcitlienl, iii.vitillation of(iw henche.v
eindlor slol)e di-ahis (with supportinA, de.clgil infoi•inaliou) if needed, and the melhod of fineil
slcihilizahon.
Fill slope cross-section of temporary erosion control berms attached to reclamation and mine
maps and will have minimum 2:1 side slope gradient, Final reclamation fill slope will be
established at edge of cut during reclamation of mine, and will have 4:1 side slope gradient.
c. In excavation(s) of unconsolidated (non -rock) materials, specify the angle of all cut slopes including
specifications for benching and sloping. Lross-sec lions fvr all cut .vlope.v must he provided on the
ninie iwip(v).
Not applicable.
d. In hardrock excavations, specify proposed bench widths and heights in feet. Provide cross -sections
of the mine excwwtion c'lecn•ly nothig the angles of the tilt slopes, widtlis of till safely henches and
mine benches, crud the expecied maxinnun depth of the execivation.
Not applicable.
7. Describe other methods to be taken during mining to prevent physical hazard to any neighboring dwelling
hoarse, public road, public, commercial or industrial building from any mine excavation. Locate all such
structures oii the mine ►nap if they crre wilhin 300 feet of any proposed excavatioli.
Not applicable. Closest dwelling is 0A mile From excavation (direct line across wooded wetland); closest
road is 0.4 mile from excavation (direct line across wooded wetland).
8. Describe what kind of barricade will be used to prevent inadvertent public access along any high wall area and
when it will be implemented. Vegetated earthen berms, appropriate fencing and adequate boulder barriers
may be acceptable high wall barricades. A con.vtruction detail/cross-section and loccilion of etich tiVe of
&wricticle to he used must he indicated on the ]nine niap(%).
No high wall areas exist in this permit area.
Caution signs, warning signs, no trespassing, and/or keep out signs will be installed at only entrance
to permit area and every 500 feet on permit boundary along Fort Island Road. Excavation area is
located 0.4 mile from nearest public road (Fort Island Road) and is only accessible from single gated
access road.
-10-

APPLICATION FOR A MINING PERMIT
9. Are acid producing minerals or soils present? Yes ❑ No Z.
If yes, how will acid water pollution from the excavation, stockpiles and waste areas be controlled?
Not applicable.
10. a. Describe specific plans (including a schedule of implementation) for screening the operation fi-om
public view such as maintaining or planting trees, bushes or other vegetation, building berms or other
measures. Aow the location of all visual screening oil the rnhie 1Nap(s) atld provide cross-sectlolls
lhronglh all proposed bel-nns or proposed spacing, sizes and sliecnes filr tree plantings.
Existing natural growth of pine trees, fields and wooded pocosin wetland around perimeter
of permit area will screen operation from public view. No additional screening planned.
b. Could the operation have a significantly adverse effect on the purposes of a publicly owned park,
forest or recreation area? If so, how will such effects (i.e., noise, visibility, etc.) be mitigated?
Mine permit area located on private -owned farmland, logged -over woodland and wetland
pocosin. Chowan Swamp Game Lands are located south orpermit area but will be separated
by 250 feet of forest & wetlands from any mining; activities. There are no anticipated adverse
eiiects to these Gamelands. One access road to Chowan Swamp Game Lands runs through
this permit area and will be maintained as such by mine operator.
11, Will] explosives be used? Yes ❑ No ®.
If yes, specify the types of explosive(s) and describe what precaution(s) will be used to prevent physical
hazard to persons or neighboring property from flying rocks or excessive air blasts or ground vibrations.
Depending; on the mire's location to nearby structures, more detailed technical information may be required
on the blasting program (such as a third -party blasting study). I,occrte the nearc�sl nffiiter occul)ied
sll•wchw•e(s) to the proposed excavation(,) on the aline reap) ard indicate its approximate dlstfowe to the
proposec excavation.
Not applicable
12. Will fuel tanks, solvents, or other chemical reagents be stored on -site? Yes ❑ No Z.
I f ye.s, describe these materials, hots, they wi11 he ,viored aril method (1l'cont(rillrllen! in case of .sp)ill. 111clicale
the localiou(s) of fill s•lorage.fcicililies on the nine maj)(s).
Not applicable.

APPLICATION FOR A MINING PERMIT
D. RECLAMATION PLAN
Describe your intended plan for the final reclamation and subsequent use of all affected lands and indicate the
sequence and general methods to be used in reclaiming this land. This must include the method of
reclamatioIl of settling ponds and/or sediment control basins and the method of restoration Or establishment
of any permanent drainage channels to a condition minimizing erosion, siltation and other pollution, 7hi.s
iufc» •nlc11io11 nnist he ilhrstrcrted oll a rec/cinwlir»1 nmp out/ must col-!-espolldchi-ectly u41h the illforincrlio►1
provided oil the mine 111ap(.$). In addllloll, de.sigrl igfoi-ination, hichlding lypiccll C1•o.ss-.VeC11o11.S, of cw/)%
pel"ma11ew channels to he conslrrlcled as pail (?fthe l-eclamation pl(w crud the loccrtioll(s) of all pel•mcmew
chcin nehl must he imlicated on the 1'ec1cuncltimi nal).
I . Excavated body of water will be left as part of reclamation of each excavation for recreatioalal use by
landowner, minimum 4 feet deep.
2. After mine excavation and removal of sand and topsoil stockpiles, all disturbed land, atTected areas
and access and service roads inside the permit area will be leveled and graded away from edge of
excavated mine pit 8 feet until graded area reaches natural level. This will create a low berm located
at the edge of the pit 1 ft high and will extend 8 feet wide away from the pit (see attached cross-
section).
3. All erosion control silt fences along access roads will be removed.
4. Other access roads to excavation area and haul roads will be graded, and returned to original
condition used as farm field access path. Processing areas will be graded and allowed to return to
natural state.
5. Graded land and all affected area will be fertilized and sown with grass seed by mine operator as per
recommendation by County Agriculture Extension Agent (attached). Ultimately all reclaimed land
from 8ff out from excavation will be returned to pasture, field and farm path,
2. Is an excavated or impounded body of water to be lelf as a part of the reclamation? Yes ® No ❑.
1f ves, ilhtwi- rte the loccrliolr of the hodv(,) of ►iwter oil the rec•lcvm:ahm mul) and provide cr .ycalecl
cro•s,�-,seclion(s) lln-ough the pi,ol)o.wd hod),(,) of ij,cwe!-. The minimum water depth must be at least 4 feet,
measured from the normal low water table elevation, unless information is provided to indicate that a more
shallow water body will be productive and beneficial at this site.
Will the body(s) of water be stocked with fish? Yes ❑ No ®.
If yes, specify species.
3. Describe provisions for safety to persons and to adjoining property in all completed excavations in rock
including what kind of permanent barricade will be left. Acceptable permanent barricades are appropriate
fencing, large boulders placed end -to -end, etc. Coiist!'ilclloti detail./' crud k)ccltlo/is of all pernralrew
hcn•1•icclde,s must he 47(,m ll oil the reclonlcttion mcrp.
Not applicable. No excavation in rock.
_12_

APPLICATION FOR A MINING PERMIT
4. indicate the method(s) of reclamation of overburden, refuse, spoil banks or other such on -site mine waste
areas, including specifications for benching and sloping. I heal eross-seclions arrd locations.for such
arects Writsi he provided on the reclatnalion map.
No mine site waste areas will exist; topsoil and sand stockpiles only.
a. Describe reclamation of processing facilities, stockpile areas, and on -site roadways.
No processing facilities exist.
Stockpiles will be totally removed from processing areas; sedimentation berms adjacent to excavated
area are to be removed and will be filled, graded and sloped away from edge of excavated mine pit 8
feet until graded area reaches natural land level. Stockpile areas will be graded and leveled to flat
natural ground level. All stockpile areas will be fertilized and seeded with grass by mine operator at
end of mining operation. Stockpile and affected areas will be returned to agricultural use by
landowner.
All onsite haul roads in immediate vicinity of excavation will be graded and leveled to flat natural
ground level, and then fert.ilized and seeded with ground cover by the owner. A l Ofi wide field path
will remain around perimeter of finished pond for owner access
b. Will any on -site roadways be left as part of the reclamation? Yes ❑ No ®,
f f yvs, identify .S-I(e T roelch qvs on the r eeleurralioll nvcrp aird pro ricle de&lils ou pernrarreirl rocrcl and ditch
litre slahilizalion.
Pre-existing access road (2.565-ft single lane soil path) from Fort Island Road to main mine site area
will be returned to pre-existing standard during reclamation. The access roads will be constantly
maintained during mining operations, and will be reclaimed by grading, leveling, and repairing
potholes as necessary. Pre-existing ditches will be maintained and repaired as necessary, and returned
to pre-existing standard during reclamation. A l Oft wide field path will remain around perimeter of
finished ponds for owner access.
6. Describe the method of control of contaminants and disposal of scrap metal, junk machinery, cables, or
other such waste products of mining. (Note definition of refuse in The Mining Act of 1971.)
No off -site generated waste shall be disposed of on the mine site without plior written approval
from the NC Department of Environment and Natural Resources, Land Quality Section and either
the Division of Waste Management (DWM) or local governing body. If a disposal permit has been
issued by DWM for the site, a copy of said permit must be attached to this application. All
teml)orm), card pernionerrt infuse disposal areal' nutst he clear'Itl delinectled on the rnhie map(%) antl
reclanuaiou ntap, clang )rilh a li.yt r fVlems to he iAs j)o.%•e(J nr setrd areas.
Any and all scrap metal, junk, cables or other such non -original waste materials will be removed from
mine premises by mine operator and disposed of properly at Gates County Landfill, I-lobbsville, NC.
All topsoil or sand excavated by mining operation will be removed from premises before reclamation.
No off site generated waste will be disposed of on -site.
_13_

APPLICATION .FOR A MINING PERMIT
7. Describe your plan for revegetation or other surface treatment of the affected areas. This plan must
include recommendations for year-round seeding, including the time of seeding, and the amount and type of
seed, fertilizer, fine and mulch per acre. The recommendations must include general seeding instructions
for both permanent and temporary revegetation. Revegetation utilizing only tree plantings is not
acceptable. Recommendations can be sought from:
a. Authorized representatives of the local Soil and Water Conservation District;
b. Authorized representatives of the Division of Forest Resources, Department of Environment and
Natural Resources;
c. Authorized county representatives of the North Carolina Cooperative Extension Service, specialists
and research faculty with the Colleges of Agriculture and Life Sciences and Forest Resources at
North Carolina State University;
d. North Carolina licensed landscape architects;
e. Private consulting foresters referred by the Division of Forest Resources, Department of Environment
and Natural Resources;
f N.C. Erosion and Sedimentation Control Planning and Design Manual;
g. N.C. Surface Mining Manual: A Guide for Permitting, Operation and Reclamation;
h. Others as may be approved by the Department.
LIME - RATE OF APPLICATION (tons/acre):
0.5 ton / acre upon soil test
FERTILIZER - ANALYSIS AND RATE OF APPLICATION (pounds/acre)'.
10:10:10 fertilizer, 430 lbs / acre, Spring, Summer & Fall
SEED - TYPE(S) AND RATE(S) OF APPLICATION INCLUDING YEAR-ROUND SEEDING
SCHEDULE (pounds/acre): [NOTE: Include Legumes]
Seed Types: Seeding Dates: Seeding Rates:
Kentucky Fescue April 250 lbs / acre
Rye Grass November 150 lbs / acre
Bermuda Grass May 85 lbs. / acre
MULCH -TYPE AND RATE OF APPLICATION (pounds/acre) AND METHOD OF ANCHORING:
Not applicable.
OTI-IER VEGETATIVE COVERS — TYPE (S) AND RATE (S) OF APPLICATION INCLUDING
SEEDING SCHEDULE (pounds/acre, trees/acre, spacing of trees/shrubs, etc):
Not applicable.
Revegetation and/or reforestation plan approved by:
Signature Date September 7, 201 1
Print Name
Title
Agency North Carolina Cooperative Extension Service
-14-

APPLICATION FOR A MINING PERMIT
E. DETERMINATION OF AFFECTED ACREAGE AND BOND
t he folloN)rrlg ho►td calculcltlon 11'or'ksheel is to he used to establish Crn appropr'icae bond (hcrsed rtpou ct !"ange,
of S500 to 55, 000 per affeeled ciciv) for each permitted mine site hcrsecl ill)on the cicrecrge crpproiec1 by the
I-)epal•Itnew to he affe( C'L!dllrlNiC� the hfL' Uf thL' rrlfl!l17 T �)eYllrlt. I'!eClse lllSel t 111Ec L'lr Jro_rllHc7le ctciea je or' each
crs1)ect of the miltiil r operation, thal jwy inlelld_to (iff& a durin , the life o Ihir s jnigh permit On a(kidio►!
nleclse insert the o nroinlate r•eelcanation cosllcicre fol" each ewevoi-v fr-om the .Schedule ofRecicunallou Costs
nrohided with ]his (molicalion form) OR you ew) deter to the l.)encrr'tulent to calculclle vour ho►rcl for you based
AFFECTED
RECLAMATION
RECLAMATION
CATEGORY
ACREAGE
COST/ACRE*
COST
Tailings/Sediment Ponds:
Ac.
X
$
/Ac.
_ $
Stockpiles:
Ac.
X
$
/Ac.
_ $
Access Roads:
1.99 Ac.
X
$
1800 /Ac.
_ $
3582
Processing Area:
.1.79 Ac.
X
$
.1800 IAc.
— $
3222
Mine Excavation:
18.82 Ac.
X
$
500 /Ac.
_ $
9410
Unexcavated Buffers (roads, berms):
7.64 Ac.
X
$
1800 IAc.
— $
13,752
TOTAL AFFECTED AC.:
30.24 Ac.
(TOTAL PERMITTED AC.:
322.6 Ac.)
Temoorary & Permanent Sedimentation & Erosion Control Measures:
Divide the TOTAL AFFECTED AC. above into the following two categories: a) affected acres that drain into
proposed/existing excavation and/or b) affected acres that will be graded for positive drainage where measures will be
needed to prevent offsite sedimentation and sedimentation to onsite watercourses and wetlands.
a) Internal Drainage 30.24 Ac.
b) Positive Drainage Ac. X $1,500.00 = $
SUBTOTAL COST: $ 29,966
Inflation Factor:
0.02 X SUBTOTAL COST: $ 5 99.3 2 X Permit Life ( l to 10 years): 10
INFLATION COST: $ 5993.20
TOTAL COST = SUBTOTAL COST+ INFLATION COST = $ 35,959.20
Total Reclamation Bond Cost: $ 35,900
(round down to the nearest $100.00)
-15-

APPLICATION FOR A MINING PERMIT
F. NOTIFICATION OF ADJOINING LANDOWNERS
The "Notice" form, or a facsimile thereof, attached to this application must be sent certified or registered mail,
return receipt requested, to:
,I) the chiefadministrative oflicerofeach county and municipality in which any part ofthe permitted
area is located as indicated on the mine map(s);
(2) all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor
of the mine tract, all owners of record of tracts adjoining these tracts must be notified (that are
within 1,000 feet of the mining permit boundary) as indicated on the mine ruap(s); and
(3) all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary which lie directly across and are contiguous to any highway, creek, stream, river,
or other watercourse, railroad track, or utility or other public right-of-way. If an adjoining tract is
owned or leased by the applicant or is owned by the lessor of the mine tract, all owners of record of
tracts adjoining these tracts must be notified (that are within 1,000 feet of the mining permit
boundary) as indicated on the mine map(s). "Highway" means a road that has four lanes of travel
or less and is not designated as an Interstate Highway.
The only exception to the above method of giving notice is if another means of notice is approved in advance by
the Director, Division of' Land Resources.
A copy of a tax map (or other alternative acceptable to the Department) must be mailed with the completed
"Notice" form (the proposed overall permit boundaries and the names and locations of all owners of
record of lands adjoining said boundaries must be clearly denoted on the tax map).
The "Affidavit of Notification" attached to this application must be completed, notarized and submitted to the
Department, with the remainder of the completed application form, before the application will be considered
complete.
THIS SECTION MUST BE COMPLETED FOR ALL APPLICATIONS FOR NEW MINING PERMITS
AND ALL MODIFICATIONS OF A MINING PERMIT TO ADD LAND TO THE PERMITTEDAREA, AS
REQUIRED BY NCGS 74-50(bl).
SEE THE NEXT TWO PAGES FOR THE "NOTICE" FORM AND THE "AFFIDAVIT OF
NOTIFICATION"
-16-

NOTICE
Pursuant to provisions G.S. 74-50(b I ) of The Mining Act of 1971, Notice is hereby given that
John R. Lane, Jr. has applied on --September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 1612 Mail Service Center, Raleigh, North Carolina 27699-1612, for (check one):
® a new surface mining permit,
❑ a modification of an existing surface mining permit to add land to the permitted area; or
❑ a modification of an existing surface mining permit to add land to the permitted area with no disturbance
in the area proposed. Please note that future modification(s) may be submitted by the applicant to
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine sand_& topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
south of Eure, NC offlnear road Fort [stand Road
(Direction) (Nearest Town) (Number/Name)
in Gates County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(b1), the mine operator is required to make a reasonable ef3'ort, satisfactory to the
Department, to notify ail owners of record, both public and private, of ail tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract,
all owners of record of tracts adjoining these tracts must be notified (that are within 1,000 feet of the mining permit
boundary). In addition, the mine operator must also notify the chief administrative officer of the county or
municipality in which any part of the permitted area is located. Any person may file written comment(s) to the
Department at the above address within thirty (30) days of the issuance of this Notice or the Fling of the application
for a permit, whichever is later. Should the Department determine that a significant public interest exists relative to
G.S. 74-51, a public hearing will be held within 60 days of the end of tile 30-day comment period specified above.
A copy of the permit application materials is on file and available for public review during normal business hours
at the above listed address as well as at the appropriate regional office. For information regarding the
hies of the g_ please in telephone number:
sped, a proposed mining activity, lease contact the applicant at the following
[phone] . For information on the mining permit application review process,
please contact the Mining Program staff` at [phone]. Please note that the Department will consider any
relevant written comments/documentation within the provisions of the Mining Act of 1971 throughout the
ap plication review process until a final decision is made on the application.
Thomas C. & Nail L. Coxe
613 Court Street Gatesville, NC 27938 John R. Lane, Jr.
(Addressee/Owner of Record's (Name of Applicant: Include Contact Person
Name and Address) & Company Name, if Applicable)
September 7, 2011 433 Gates School Road, Gates, NC 27937
(Date of Issuance of this Notice/ (Address of Applicant)
Mailed to Addressee/Owner of Record)
-17-

NOTICE
Pursuant to provisions G.S. 74-50(bI)of The Mining Act of 1971, Notice is hereby given that
John R. Lane, Jr. has applied on September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 1612 Mail Service Center, Raleigh, North Carolina 27699-1612, for (check one)-
® a new surface mining permit,
❑ a modification of an existing surface mining permit to add land to the permitted area; or
❑ a modification of an existing surface mining permit to add land to the permitted area with no disturbance
in the area proposed. Please note that future modification(s) may be submitted by the applicant to
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine sand & topsoil on 18,82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
South of Eure, NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates County.
*SEE ATTACHED MAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(bl), the mine operator is required to make a reasonable efTort, satisfactory to the
Department, to notify all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract,
all owners of record of tracts adjoining these tracts must be notified (that are within 1,000 feet of the mining permit
boundary). In addition, the mine operator must also notify the chief administrative officer of the county or
municipality in which any part of the permitted area is located. Any person may file written comnrent(s) to the
Department at the above address within thirty (30) days of the issuance of this Notice or the filing of the application
for a permit, whichever is later. Should the Department determine that a significant public interest exists relative to
G.S. 74-51, a public hearing will be held within 60 days of the end of the 30-day comment period specified above.
A copy of the permit application materials is oil file and available for public review during normal business hours
at the above listed address as well as at the appropriate regional office. For information regarding the
specifics of the Dronosed mining activity, please contact the apDlicant at the follow ne teleWione number:
[phone] . For information on the mining permit application review process,
please contact the Mining Program staff at [phone]. Please note that the Department will consider any
relevant written comments/documentation within the provisions of the Mining Act of 1971 throughout the
application review process until a final decision is made on the anplication.
NC Wildlife Resources Commission
Div. of Wildlife Management, C/O Isaac Harrold
1722 Mail Service Center Raleigh, NC 27699-1722 _ John R. Lane, Jr.
(Addressee/Owner of Record's (Name of Applicant: Include Contact Person
Name and Address) & Company Name, if Applicable)
September 7, 2011 433 Gates School Road Gates NC 27937
(Date of Issuance of this Notice/ (Address of Applicant)
Mailed to Addressee/Owner of Record)

NOTICE
Pursuant to provisions G.S. 74-50(b I ) of The Mining Act of 1971, Notice is hereby given that
John R. Lane, Jr. has applied on September 2011
(Applicant Name) (Date)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 1612 Mail Service Center, Raleigh, North Carolina 27699-1612, for (check one):
® a new surface mining permit,
❑ a modification of an existing surface mining permit to add land to the permitted area, or
❑ a modification of an existing surface mining permit to add land to the permitted area with no disturbance
in the area proposed. Please note that future modification(s) may be submitted by the applicant to
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine sand & topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
South of Eure, NC offlnear road Fort island Road
(Direction) (Nearest Town) (Number/Name)
in Gates County.
*SEE ATTACI-IE.D NIAP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(b]), the mine operator is required to make a reasonable effort, satisfactory to the
Department, to notify all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract,
all owners of record of tracts adjoining these tracts must be notified (that are within 1,000 feet of the mining permit
boundary). In addition, the mine operator must also notify the chief administrative officer of the county or
municipality in which any part of the permitted area is located. Any person may file written comment(s) to the
Department at the above address within thirty (30) days of the issuance of this Notice or the tiling of the application
for a permit, whichever is later. Should the Department determine that a significant public interest exists relative to
G. S. 74-51, a public hearing will be held within 60 days of the end of the 30-day comment period specified above.
A copy of the permit application materials is on file and available for public review during normal business hours
at the above listed address as well as at the appropriate regional office. For information regarding the
specifics of the nronosed minim activity, please contact the annlicant at the following teleuhone number:
[phone] _ . For information on the mining permit application review process,
please contact the Mining Program staff at (9]9) 73 3-4574. Please note that the Department will consider any
relevant written comments/documentation within the provisions of the Mining Act of 1971 throughout the
a lication review rocess until a final decision is made on the application.
Nature Conservancy
4705 University Dr., Ste 290 , Durham, NC 27707 John R. Lane, Jr.
(Addressee/Owner of Record's (Narne of Applicant: Include Contact Person
Name and Address) & Company Name, if Applicable)
September 7,_201 1 433 Gates School Road, Gates, NC 27937
(Date of Issuance of this Notice/ (Address of Applicant)
.Mailed to Addressee/Owner of Record)
-19-

NOTICE
Pursuant to provisions G.S. 74-50(b 1) of Tile Mining Act of 1971, Notice is hereby given that
John R. „Lane, Jr. -- has applied on September 2011
(Applicant Name) (Da(e)
to the Land Quality Section, Division of Land Resources, North Carolina Department of Environment
and Natural Resources, 1612 Mail Service Center, Raleigh, North Carolina 27699-1612, for (check one):
® a new surface mining permit,
❑ a modification of an existing surface mining permit to add land to the permitted area; or
❑ a modification of an existing surface mining permit to add land to the permitted area with no disturbance
in the area proposed. Please mote that future modification(s) may be submitted by the applicant to
allow disturbance within this area without re -notification of adjoining landowners.
The applicant proposes to mine sand & topsoil on 18.82 acres located 2.1 miles
(Mineral, Ore) (Number) (Miles)
South of Eure, NC off/near road Fort Island Road
(Direction) (Nearest Town) (Number/Name)
in Gates County.
*SEE ATTACHED I17AP FOR PROPOSED PERMIT BOUNDARIES AND CORRESPONDING
ADJOINING LANDOWNER NAMES AND LOCATIONS*
In accordance with G.S. 74-50(bI), the mine operator is required to make a reasonable efTort, satisfactory to the
Department, to notify all owners of record, both public and private, of all tracts of land that are adjoining the mining
permit boundary; if an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract,
all owners of record of tracts adjoining these tracts must be notified (that are within 1,000 feet of the mining permit
boundary). In addition, the mine operator must also notify the chief administrative officer of the county or
municipality in which any part of the permitted area is located. Any person may fife written comment(s) to the
Department at the above address within thirty (30) days of the issuance of this Notice or the filing of the application
for a permit, whichever is later. Should the Department determine that a significant public interest exists relative to
G.S. 74-51, a public hearing will be held within 60 days of the end of the 30-day comment period specified above.
A copy of the permit application materials is on file and available for public review during normal business hours
at the above listed address as well as at the appropriate regional office. For information regarding the
specifics of the nronosed minim activity. nlease contact the annlicant at the follnwing telenhone number:
_ 4252) 398-7708 . For infornna
ease contact. the Mining Program staff at [phone]
levant written coniments/documentation within the provi:
Toby Chappell, Gates County Manager
PO Box 148, 200 Court St.,_Gatesville, NC 27938
(Addressee/Owner of Record's
Name and Address)
September 7, 2011
(Date of Issuance of this Notice/
Mailed to Addressee/Owner of Record)
n on the mining permit application review process,
'lease note that the Department will consider any
is of the Mining Act of 1971 throughout the
John R. Lane, Jr.
(Name of Applicant: Include Contact Per-sol]
& Company Name, if Applicable)
433 Gates School Road, Gates, NC 27937
(Address of Applicant)
-20-

APPLICATION FOR A MINING PERMIT
AFFI.DAVI`I' OF NOTIFICATION
I, Kenneth C. Elliott , an applicant, or an agent, or employee of an applicant, for a new
Mining Permit, or a modification of an existing Mining Permit to add land to the permitted area, from the N.C.
Department of Environment and Natural Resources, being first duly sworn, do hereby attest that the following are all
known owners of record, both public and private, of all tracts of land that are adjoining the mining permit boundary
(including, where an adjoining tract is owned or leased by the applicant or is owned by the lessor of the mine tract, all
owners of record of tracts adjoining these tracts, that are within 1,000 feet of the mining permit boundary) and that
notice of the pending application has been caused to be mailed, by certified or registered mail, return receipt
requested, to said owners of record at their addresses shown below, such notice being given on a form provided by
the Department:
(Adjoining Landowner Name)
Thomas C & Nan L. Coxe
NC Wildlife Resources, Div, of Wildlife Mamt.
Nature Conservancy _
(Address)
G 1,3_Court Street, Gatesville, NC 27038
1722 Mail Service Ctr. Raleigh, NC 27699-1722
4705 University Dr, Ste 290, Durham, NC 27707_._
(Attach additional list if necessary)
do also attest that the following individual is the chief administrative officer of the county or municipality in which
any part of the permitted area is located and that notice of the pending application has been caused to be mailed, by
certified or registered mail, return receipt requested, to said off ce at the following address:
(Chief Administrative Officer Name)
[Ve.. City Manager, County Manager, Mayor, etc.]
Toby Chappell, County Manager
(Address)
PO Box 148, 200 Court St., Gatesville, NC 27938
The above attestation was made by me while under oath to provide proof satisfactory to the Department that a
reasonable effort has been made to notify all known owners of record, both public and private, of all tracts of land
that are adjoining the mining permit boundary (including, where an adjoining tract is owned or leased by the applicant
or is owned by the lessor of the mine tract, all owners of record of tracts adjoining these tracts, that are within 1,000
feet of the mining permit boundary) and the chief administrative officer of the county or municipality in which any
part of the permitted area is located in compliance with N.C.G.S. 74-50(bl) and 15A NCAC 5B .0004(d).
understand that it is the responsibility of the applicant to retain the receipts of mailing showing that the above notices
were caused to be mailed and to provide thern to the Department upon request.
Signature of Applicant or Agent
_September 8, 2011
Date
If person executing Affidavit is an agent or employee of an applicant, provide the following information:
Name of applicant: John R. Lane, Jr.
Title of person executing AfFidavit Agent for John R. Lane. Jr.
1, a Notary Public of the County of
State of North Carolina, do hereby certify that.
appeared before me this day and tinder oath acknowledged that the above Affidavit was made by him/her.
Witness my hand and notarial seal, this
day of 20
Notary: my Commission expires:
-2E-

APPLICATION FOR A MINING PERMIT
G. LAND ENTRY AGREEMENT
We hereby grant to the Department or its appointed representatives the right of entry and travel upon our lands or
operation during regular business hours for the purpose of making necessary field inspections or investigations as may be
reasonably required in the administration of the Mining Act of 1971 pursuant to G. S. 74-56.
We further grant to the Department or its appointed representatives the right to make whatever entries on the land as
may be reasonably necessary and to take whatever actions as may be reasonably necessary in order to carry out, reclamation
which the operator has failed to complete in the event a board forfeiture is ordered pursuant to G.S. 74-59.
LANDOWNER:
Signature:
Print Name: J. Roger & Rita H. Lane
(Title, if applicable)
Company
(If applicable
Address: PO Box 485
Gatesville, NC 27938
Telephone: (
Date Signed:
APPLICANT:
Signature:*
Print Name: John R. Lane, Jr.
Title: Operator ---
Company:
Mine Name: Eure Sand Mine
Telephone: ( 252) 398-7708
Date Signed:
*Signature must be the same as the individual who signed Page I of this application.
One original and five (5) conies of the completed application, six (G) copies of all location maps, mine maps and
reclamation mans, and the appropriate processing fee (see next page for fee schedule) in the forma check or money
order payable to the North Carolina Department of Environment and Natural Resources must be sent to the Land
Ouality Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.
- 22 -

APPLICATION FOR A MINING PERMIT
G. LAND ENTRY AGREEMENT
We hereby grant to the Department or its appointed representatives the right of entry and travel upon our lands or
operation during regular business hours for the purpose of making necessary field inspections or investigations as may be
reasonably required in the administration of the Mining Act of 1971 pursuant to G.S. 74-56.
We further grant to the Department or its appointed representatives the right to make whatever entries on the land as
may be reasonably necessary and to take whatever actions as may be reasonably necessary in order to carry out reclamation
which the operator has failed to complete in the event a bond forfeiture is ordered pursuant to G.S. 74-59.
LANDOWNER:
Signature
Print Name: Charles T. Hofler, Jr.
(Title, if applicable)
Company
(If applicable)
Address: f 81 NC 37 South
Gatesville, NC 27938
Telephone: (
Date Signed:
APPLICANT:
Signature:*
Print Name: John R. Lane, Jr.
Title: Operator
Company:
Mine Name: Eure Sand Mine
Telephone: ( 252 ) 398-7708
Date Signed:
*Signature must be the same as the individual who signed Page I of this application.
One original and five (5) copies of the completed application, six (6) copies of aII location maps, mine maps and
reclamation maps, and the appropriate processing fee (see next page for fee schedule) in the form a check or money
order payable to the North Carolina Department of Environment and Natural Resources must be sent to the Land
uality Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program stafl'at (919) 733-
4574.
- 23 -

APPLICATION FOR A MINING PERMIT
G. LAND ENTRY AGREEMENT
We hereby grant to the Department or its appointed representatives the right of entry and travel upon our lands or
operation during regular business hours for the purpose of making necessary field inspections or investigations as may be
reasonabl}f required in the administration of the Mining Act of 1971 pursuant to G.S. 74-56.
We further grant to the Department or its appointed representatives the right to make whatever entries on the land as
may be reasonably necessary and to take whatever actions as may be reasonably necessary in order to carry out reclamation
which the operator has failed to complete in the event a bond forfeiture is ordered pursuant to G.S. 74-59.
LANDOWNER:
Signature
Print Name: George Mac Miller
(Title, if applicable)
Company
(If applied le)
Address: 310 NC Hwv 137
Gatesville, NC 27938
Telephone: (
Date Signed:
APPLICANT:
Signature: *
Print Name: John R. Lane, Jr.
Title: Operator
Company:
Mine Name: Eure Sand Mine
Telephone: ( 252 ) 398-7708
Date Signed:
*Signature must be the same as the individual who signed Page 1 of this application.
One original and live (5) copies of the completed application, six (6) copies of all location maps, mine maps and
reclamation mans, and the appropriate processing fee (see next Page for fee schedule) in the form a check or money
order payable to the North Carolina Department of Environment and Natural Resources must be sent to the Land
Quality Section Central Office at the address listed on the front cover of this application form.
Inquiries regarding the status of the review of this application should be directed to the Mining Program staff at (919) 733-
4574.
-24-

APPLICATION FOR A MINING PERMIT
MINING FEE SCHEDULE
A nonrefundaltle permit application processing, fee when tiling fora new mining permit, a major permit modification or a renewal hermit is
required as follows:
0-25 acres 26-i-acres
New Permit Applications $3,750.00 $5,000.00
Pennit Modifications $750.00 $1,000.00
Permit Renewals $750.00 $1,000.00
Transfers/Minor Modifications* $100.00 $100.00
" A uunrrl' lidahie SI11t9.t111 permit application processing fee is required for minor permit muditicrdionx. 1linur Permil nunlilicalions include uwuer-ship Ilyrn3fevs, name
Changes, bums snhstitutients and permit renewals where the mine is i metive and fully stabilized. A mirror Pennil nlodificatlon also includes lauds added to so permitted area,
umside of the nlfrlf imm permit buffer zone m(lafrernents, where no plans firs mfnfng related disturbance of Iflc added I:uuls have been approved. All other changes an,
corisiderrd major Permit modifications.
Acres fi>r newPer1rlits and mues'al Permits means the Total acreage at the site. Acres furmajor modification of permits rsteans that area of la rid atleeted I>y the IliditkMion
within the Permitted mine area, or any additional land that is to he distm,bed and added to an c.isting pettnitted :lrca, nr both.
-25-

APPLICATION FOR A MINING PERMIT
There are seven Land Quality Section (LQS) Regional Offices. Use the map below to locate the Regional Office
serving your county.
Asheville Regional Office
• Counties: Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey
• Address: 2090 U.S. Highway 70, Swannanoa, NC 28778
• Voice:828.296.4500
• FAX:828299,7043
Fayetteville Regional Office
• Counties: Anson, Bladen, Cumberland, Harnett, Hoke, Montgomery, Moore, Richmond, Robeson, Sampson,
Scotland
• Address: 225 Green Street, (Systel Building), Suite 714, Fayetteville, NC 28301-5094
• Voice:910.433.3300
• FAX:910,486.0707
Mooresville Regional Office
• Counties: Alexander, Cabarrus, Catawba, Cleveland, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, Stanly,
Union
• Address: 610 East Center Ave., Suite 301, Mooresville, NC 28115
• Voice:704.663.1699
• FAX:[phone]
Raleigh Regional Office
• Counties: Chatham, Durham, Edgecombe, Franklin, Granville, Halifax, Johnston, Lee, Nash, Northampton,
Orange, Person, Vance, Wake, Warren, Wilson
• Address: 1628 Mail Service Center, Raleigh, NC 27699-1628 or 3800 Barrett Drive, Raleigh, NC 27609
• Voice- 919.791.4200
• FAX: 919.571,4718
Washington Regional Office
• Counties: Beaufort, Bertie, Camden, Chowan, Craven, Currit.uck, Dare, Gates, Greene, Hertford, Hyde, Jones,
Lenoir, Martin, Pamlico, Pasquotank, Perquirnans, Pitt, Tyrrell, Washington, Wayne
• Address. 943 Washington Square Mall, Washington, NC 27889
• Voice- 252.946.6481
• FAX:[phone]
-26-

APPLICATION FOR A MINING PERMIT
LAND QUALITY REGIONAL OFFICES (cmitinued)
Wilmington Regional Office
• Counties: Brunswick, Carteret, Columbus, Duphn, New Hanover, Onslow, Pender
• Address: 127 Cardinal Drive Extension, Wilmington, NC 28405
• Voice:910.796.7215
• FAX:[phone]
Winston-Salem Regional Office
• Counties: Alamance, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
• Address: 595 Waughtown Street, Winston Salem, NC 27107
• Voice- 336.771.5000
• FAX:[phone]
-27-

APPLICATION FOR A MINING PERMIT
SCHEDULE OF RECLAMATION COSTS
(Based upon range of $500 - $5,000 ner affected acre)
COMMODITY CODES: SG = Sand and/or Gravel, GS = Gemstone, Borrow = f3orrow/fill dirt, CS = Crushed Stone,
DS = Dimension Stone, FS = feldspar, M7 = Mica, LI = Lithium, PF = Pyrophyliite, OL = Olivine,
KY = Kyanite/Sillimanite/Andalusite, PH = Phosphate, CL = Clay/Shale, PE = Peat, AU = Gold, TI =Titanium, and OT=
Other
Tyne
T/S Ponds
S.piles
Wailes
P.area/H.R._
Mine^Excay.
SG, GS,
$500/ac.(L)
$1800/ac.
$2000/ac.
$1800/ac.
$500lac.(L)
Borrow
1500(FI)
$2000(PD)
CS, DS,
500(L)
1800
2000
2000
500(L)
FS, MI,
1500(Fl)
2500(1'D)
Ll, PF, OL, KY
PH
I000(L)
2500
5000
5000
2000(L)
2500(FI)
5000(PD)
CL
1000(L)
2500
5000
5000
2000(L)
2500(FI)
3700(PD)
PE, AU,
]000(L)
2500
3000
3500
2000(L)
T1, OT
2500(FI)
5000(1'D)
(L) = reclamation to a lake and revegetating sideslopes
(Fl) = reclamation by filling in and revegetating
(PD) = reclamation by grading for positive drainage & revegetating
AS PER NCAC 15A 5B.0003, IF YOU DISAGREE WITH THE BOND AMOUNT DETERMINED BY THE
BOND CALCULATION WORKSHEET, YOU MAY SUBMIT AN ESTIMATE OF RECLAMATION COSTS
FROM A 'THIRD PARITY CONTRACTOR. SAID ESTIMATE MUST BE PROVIDED WITHIN 30 DAYS TO
THE FOLLOWING ADDRESS: Mining Program, Land Quality Section, 1612 Mail Service Center, Raleigh,
North Carolina 27699-1612
ALL ESTIMATES MUST INCLUDE THE FOLLOWING. AS A MINIMUM:
• FINAL GRADING COSTS PER ACRE
• LIME AND FERTILIZER COSTS PER ACRE
• YEAR-ROUND SEEDING MIXTURE COSTS PER ACRE (FROM APPROVED REVEGETATION
PLAN IN APPLICATION/PERMIT DOCUMENT)
• MULCH AND ANCHORING COSTS PER ACRE
• ANY OTHER RECLAMATION COSTS NECESSARY TO COMPLY WITH THE APPROVED
RECLAMATION PLAN FOR THE SITE IN QUESTION
YOU WILL BE NOTIFIED AS SOON AS POSSIBLE OFTHE DIRECTOR'S FINAL BOND DETERMINATION.
-28-

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
Applicable lUes: ❑ Coastal SW -- 1995 ❑ Coastal SW — 2008 ❑ I'll 11 - [lost Construction
(Seidel all that apphl) ❑ Ntorl-Coastal SW- I-IQW/ORW Waters ❑ Uruversaf Stormwater iVlanag;ement 1'lat7
❑ Other WQ M rrnt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality ((�� j� [�J
STORMWATER MANAGEMENT PERMIT APPLICAT MATH U 1
This form tntry be photocopies! for rise (is tin original
I. GENERAL INFORMATION
DEC - 2 2011
1. Project Nranie (subdivisiori, facility, or establishment name - should be consistei�t�i� � X R U i NCH
plans, specifications, letters, operation and maintenance agreements, etc.):
2. Location of Project (street address):
Fort Island Koad
City:Eure, Rt. I County:Gates _ 7ip:27937
3. Directions to project (from nearest major intersection):
Froin intersection of NC 37 and NC 137 in downtown Gatesvill{; g{> tiyt 5t 4.4 miles on NC 137 to intersertic311
of Taylorylitl Road (SR 1118), travel south on Taylor Mill Road 1-( miles, taking second paved left onto Fort
kland Road (SR 1220), travel south 0.5 mile on Fort Island ]load to dirt road entrance inn the ririglit.
4. Latitude:36' 23' 55.26" rNr Longitude:76' 5W 54.23" W of the main entrance to the project.
11. PERMIT INFORMATION:
l . a. Specify whether project is (check one): ®Neap• ❑:Modification
If this application is being submitted as tilt result of a modification to an existing permit, list the existing;
hermit number its issue elate (if known) and the status of
COIIS,trUdio n: ❑Not Started ❑Partially Completed* ❑ Completed* *proz,ide a desi'ntr's
certification
2. Specify the type of project (check one):
®Lose Density ❑High Density ❑Drains to an Offsite Stormwater System ❑other
3. If this application is being; submitted as the: result of a previously returned application or a letter From
DWQ requesting a state Stormwater management permit application, list the stormwater project nurnber,
if assigned, and the previous ilmne of the project, if different than currently
proposed,
4. a. Additional Project kequirements (check applicable blanks; information on required state permits can be
obtained by contacting; the Customer Service Center at 1-877-623-6748):
[](:A,MA ,Viajor NSedimentation/Er'osion Control: 30.24 ac of ]Disturbed Area
❑N]'DFS Industrial Stormwater N404/401 Permit: Proposed Impacts 0.482 acres wetlands
b.If any cif these Iiernlits have already bec:ri acquired V,)ease provide the PN-
Proje(�t ame, Project/Permit
Number, issue Mate and the type of each permit:l)LK Minirig Permit submitted Sept 2011, pending, U5A(�F
1�\r NW14 permit sul�m.itted Oct 2071, g�ending_pendingN(:G020000 mining) vastCwater permit
submitted Nov 20.1 I, pending. -
Form SWU-101 VeNion MJun2010 Page 1 of 6

III. CONTACT INPORMA"I"ION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc, who myns the pro)ect):
Applicant/Organization: John R. Lane, In
Signing Official & Title:)ohn R. Lane, Jr., Owner
b.Contact information for person listed in item la above:
Street Address:433 Cates School Road
City:Cates Stato: N�� - -_ _ - p i � 27937
Mailing Address (if applicable):433 Dates Schooll Road_ --
City:( aces State:sNC Zip:27937
Phone: (252 ) 357-1279 Fax: ( }
Email: ritalane��embar�maii.com
Please check the appropriate box. The applicant listed above is:
❑ The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Pun:haser* (Attach a copy of the Pending sales agreement and complete Contact Info rmatiurz, item 20
a.nd 2b below)
® Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, it you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Ovener/Organization:. Ro er & Rita H. Lane
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Address:433 Gates School Road
City:Cates State:NC. Zip:27937
Mailing Address (ij'applicable):PO Box 187
City:Gates Statc:NC Zip:27937
Phone: (252 ) 357-1279 Fax:
Email:ritalanc�cambas•��mail.conz ... ,,, ..--
3. a. (Optional) Print the narne and title of another contact such as the project's construction supervisor or other
person who ran answer questions about the project:
Other Contact Person/Organizahon: Ken Elliott/ ElliottConsuldng
Signing Official & Title:hcn Elliott, consulting
b.Contact information for person listed in item 3a above:
Mailing Address:622 Ruck Hock Creek.Road
City: Edenton -_
Phone: (2S2 ) 339-9021
[e-mail]
State:\r . Zip:279 32
Fax: ( )
4. Local jurisdiction for building permits: Cates County Planning Office
Paint of Contact:Mor ran lethro Phone #: [phone] l x 170()
Form SWU-101 Version 071un2010 Farr' 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, i_irie1 summarize how the stormwa ter runoff Will be treated.
Vegetated sand berms around 1 all excayLqiQn Perim erti rah Jr ina >., f s )rrnwa r in ex Cava is n ar i
into pit ether storrnwater fac'c'ess roads) will sheet -flow across into adjacent g��cosin wetlands; other storm-._
Water Will growic absorb or drain to ac�itarent,pc�c'r�sin wetlands
2. a, if claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Cwlstal SW — 1995 ❑ Ph 11 — Post Construction
3. Stormwater runoff from this project drains to the Chawan River basin.
4. Total Property Area: 322.E a[:Cl'.S 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) —Total Coastal Wetlands Area (5) —Total Surface Water Area (6) = Total 1'roject
Area+: 322.E 2 parcels acres
Total project area shall be calcydated to exclude the followin the normal pool of impounded structures, the area
between (he banks of streams rind rivers, the area below the kormal High IN'ater WHW) line or r'lcan High Water
(MHW) line, and coastal Wetlands landulard from the NH W (or MHW) line. The resultant project area is used to
calculate ovorall percent built upon area (BCIA). Non -coastal wetlands landward of the NHW (or MH W) line mml
be inchided in the total project area.
3. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 3.54
9. Flaw many drainage areas does the project have? l (For high density, count.] jor each proposed engineered
stormrr titer BMR For low density and other projects, use 1 for the whole property/ area)
10. Complete the following; information for each drainage area identified in Project Information item 9. If there
are more than tour drainage areas in the project, attach an additional sheet with the information for each
area provided in the same format as below.
Basin lnfornaation
Drainage Area _
Dralmi >e Area
Oraina re Area
Draiiia re Area _
Receiving Stream Narne
Chowan Diver
Stream Class
13, NSW
Stream Index Number
Total Drainage Area (sf)
On -site Drainage Area (sf)
Off -site Drainage Area (4)
Proposed Impervious Area**
(sf)
11.42AC
Impervious Area** (total)
3.54%
Im pervious" Surface Area
Drainage Area _
Draina ye Area
Drainage Area
Draina >e Area
On -site Buildings/sots (sf)—
On-site Streets (sf)
294,000
Un-site Parking; (sf)
On -site Sidewalks (sf)
Other on -site (sf)
203,000
Future (sf)
Off-si to (sf)
Existing; 13UA*** (sf)
0
Total (sf):
* Stream Class and Index Number can bedetermined at:
* linrzis defined as the built ripon area including, but not limited to, 1wildings, roads, parking areas,
sirlmialks, gravel areas, etc.
Farm SW U-101 Version 07Jun2010 Pave 3 of 6

Report oral,/ that amount of existing BUA that will remain aftor dt7vloprnent. Do not report and existing BLIA that
is to be removed and which will be replaced by new BLIA.
11. l-losv ;vas the off -site impervious area listed above determined? Provide documentation.
Projects in Union County: C:utltcrct Ii4t/Q Central Office staff ro check if the projet,•t is loctned rvirhin a 'Threatened &
Endangered ,Species rralershed that nrrry be subiect to more stringent srornnvarer requi.remenrs as per NC,-1 C 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (0&M) forms
must be submitted for each t3j'V11' specified for this project. The latest versions of the forms can be downloaded
from H[r % ' •( Irk i1.i}s1_�s'!3i'.Sii' �[t'�'tl; '}_� ;�!..}/SU1f�?111._! Ili:?I?lEfii.
VI. SU13MITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality
(DWQ). A complete package includes all of the items listed below. A detailed application instruction sheet
and BMP checklists are available from htt �: �ort�rl.nidenr.e r}; wel? [t�1 iv,/ titatesw /fc}ri is does. The
complete application package should be submitted to the appropriate DWQ Office. (The appropriate office
may be ftlund by locatin,, project on the interactive online reap at
]'lease indicate_that _the_foilowi_ng i_ec�uired information have heen.pro_vided Eby iriitiali.ng in the spare
provided for each item. All original documents MUST be signed and initialed in blue ink. Download the latest
versions for each submitted application package from
til_ciSl_�t1';'iirHll. tis�'ti,
initials
l . Original and one copal of the Stormwater Management Permit Application For in.
2. Original and one copyof the signed and notarized Deed Restrictions & Protective Covenants
Form. (if reiptired as per Part V11 below)
3. Original of theapplicable Supplement Form(s) (sealed, signed and dated) atd O&M
agreements) for each 13M P.
4. Permit application processing fee of S505 payable to NCD1 NR. (For an Express review, refer to
http://www.envhGl}z.4�rgjl��7gc5[Qnestopexpress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management for
6. A USGS map identifying the site location. If the receiving stream is reported as Class SA or the
receiving stream drains to class SA waters within r/2 mile of the site boundary, inCludC the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSIZ numbers.
d. Legend.
e, North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the. plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MI-lW or NJ-]W line of tidal
waters, and any Coastal Wetlands landward of the MI-IW or NI-1W lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of steams or rivers, and the MHW (car NHW) of tidal waters.
i. IDimensioned property/project boundary %with bearings & distances.
j. Site Layout with all 13UA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide doCumentation of qualifications and identify the person who
made the determination on the plans.
Form SWU-101 Vcrsicm 07Jun2010 Page 4 of 6

n. Existing drainage (including off -site:), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, riot as a separate document).
p. Vegetated buffers (where required).
). Copy of any applicable sails report with the associated SH WT elevations (Please identify
elevations in addition to depths) as well as a rnap of the boring locations with the existing;
elevations and boring logs. InclerdC an 8.5"x l l" copy of the NKCS County Soils map with the
project area clearly delineated, For projects with infiltration 13M1's, the report should also
include the soil type, expected infiltration rate, and the method of determining; the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHWT prior
to submittal, [phone].)
A copy of the most current property deed. Teed book: 263, 284 Page Nro: 640, 246
For corporations and limited liabifity corporations (LLC): Provide do{'unlentation from the NC;
Secretary of State or ether official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per rNCAC 21-1.1003(e). The
corporation or LLC must be listed as in active corporation in goad standing with the NC
Secretary of `hate, otherwise the application will be returned.
httu: / /v,��vw.secretars�.st�te.nc,us/Corporations/C=Search.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior" to the sale of any lot. If lot sires vary significantly or the proposed
13UA allocations vary, a table listing each lot dumber, lot size, and the allowable built -upon area inust be
provided as an attachment to the completed and notarized deed restriction form. The appropriate deed
restrictions and protective covenants forms can be do"',nloaded from
"nip )_ocu ,. 0ownload the latest versions for each
SUMLittal.A
In the instances cohere the applicant is different than the property owner, it is the responsibility of the property
owner to sign the geed restrictions and protective covenants Lorin while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signatures? below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this projec(, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and /or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing rccjuests (or irddih011al in(ornlation).
Consulting Engineer: Ken Elliott
Consulting Firm: Elliott Consulting
Mailing Address: 622 Rocky Hock Creek 1Zoad
City: Edenton State: NC _ Zip: 27932
Phone: (252 ) 339-902 t Fax:
Email: kengkenobx.corn
IX. PROPERTY OWNER AUTHORIZATION (if Cori fact Iri onnirfion, iforn 2 hi is been filled oiit, c:ompletc this
section)
1, (print or ti/pe name of person listed in Contact Information, itein 2a) Rita H. Lana, 1. Roger Lane certify that 1
own the property identified ill this permit applic picot, arld thUS give P0r1nission to (print or t 1pe name of'pe'r.son
listed in Contact Infor"niation, item 1a) John R. Lane, fr. _ with (print or type naive of organization listed in
Contact Information, item 1a) Eure Sand Mine to develop the project as currently proposed. A copy
of the lease agreement or pending property sales contract has been provided with the: submittal, which indicates
the party responsible for the operation and maintenance of the storrnwater system.
Form SWU-lot Version 07Jun2010 P i,,e 5 01' 6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my
designated agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or
defaults on their lease agreement, or pending sale, responsibility for compliance with the DWQ Stormvvater
permit reverts back to me, the property owner. As the property owner, it is my responsibility to notify DWQ
immediately and submit a completed Name/Ownership Change Form within 30 days; otherwise I will be
operating a stormwater treatment facility without a valid permit. I understand that the operation of a
stormwater treatment facility without a valid permit is a violation of NC General Statue 143-215.1 and may
result in appropriate enforcement a, 'on including the assessment of civil penalties of up to $25,000 per day,
pursuant to NCGS 143-215. .
Signature::. Date: ._ILZS =_L
I, e.C1RJ C.C'i a Notary Pub is for the State of _;{ _, County of
ear do hereby certify that t personally appeared
before me this ! � day of Nts!1Za I I and acics w d re the d 4c } n of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
X. APPLICANT'S CERTIFICATION
I, (print or hype name of person listed in Contact Information, item 1a) John R. Lane. 1r.
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwate�ules under 15A NCAC 2H .1000, SL 2006-246 (Ph. 11— Post Construction) or SL 2008-211.
'Signature:
1, , a Notary Pubbe for the State of
do hereby certify that
DateJL 117 I
County, of
personally appeared
before me this day of arid acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
Form SWU-101 Version 07Jun2010 Page 6 of 6